CN107405204A - Universally expanding cage - Google Patents

Universally expanding cage Download PDF

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Publication number
CN107405204A
CN107405204A CN 201580072593 CN201580072593A CN107405204A CN 107405204 A CN107405204 A CN 107405204A CN 201580072593 CN201580072593 CN 201580072593 CN 201580072593 A CN201580072593 A CN 201580072593A CN 107405204 A CN107405204 A CN 107405204A
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CN
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Patent type
Prior art keywords
portion
proximal
distal
end
body
Prior art date
Application number
CN 201580072593
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Chinese (zh)
Inventor
罗伯特·托马斯·哥罗兹
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爱整形外科公司
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/442Intervertebral or spinal discs, e.g. resilient
    • A61F2/4425Intervertebral or spinal discs, e.g. resilient made of articulated components
    • AHUMAN NECESSITIES
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
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    • A61F2/44Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/446Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/4455Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
    • A61F2/447Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
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    • A61F2/4611Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
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    • A61F2002/30411Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves having two threaded end parts connected by a threaded central part with opposite threads at its opposite ends, i.e. for adjusting the distance between both end parts by rotating the central part
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    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
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    • A61F2002/30538Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
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    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30579Special structural features of bone or joint prostheses not otherwise provided for with mechanically expandable devices, e.g. fixation devices
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    • A61F2002/30594Special structural features of bone or joint prostheses not otherwise provided for slotted
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    • A61F2002/4642Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis for inserting or connecting a locking mechanism

Abstract

An expandable medical implant is provided with an implantable cage body. The proximal and distal ends of the cage body may each be provided with a tapered or cam portion. The implant may further include a proximal flexure, a distal flexure, a proximal plug member having a tapered portion configured to mate with the tapered portion of the proximal end of the cage body, and a distal plug member having a tapered portion configured to mate with the tapered portion of the distal end of the cage body. The proximal plug member may be configured to move longitudinally such that the distal flexure moves and the circumference of the proximal end of the cage body resiliently expands. The distal plug member may be configured to move longitudinally such that the proximal flexure moves and the circumference of the distal end of the cage body resiliently expands. Methods are also disclosed.

Description

通用扩张融合器 Universal expansion cage

[0001] 通过引用并入 [0001] incorporated by reference

[0002] 本说明书中提及的所有出版物和专利申请通过引用以其整体并入本文,其程度如同每个单独的出版物或专利申请特别地且单独地表示成通过引用并入一样。 All publications and patent applications [0002] mentioned in this specification are incorporated herein by reference in their entirety to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.

[0003] 领域 [0003] field

[0004] 本公开总体上涉及用于稳定椎骨运动节段或其他骨节段的医疗设备。 Relates [0004] The present disclosure relates generally to a medical device for stabilizing vertebral motion segment or segments other joints. 更具体地, 本公开的领域涉及用于提供受控的脊柱矫正或其他的骨节段隔开(bond segment spacing)和/或对准(alignment)的通用扩张融合器(UEC)和使用方法。 More particularly, the present disclosure relates to the art for providing controlled spinal correction or other segments spaced apart condyles (bond segment spacing) and / or alignment (Alignment) universal expansion cage (the UEC) and methods of use.

[0005] 背景 [0005] BACKGROUND

[0006] 传统的椎间融合器(spine cage)或植入物通常特征在于菜豆形的主体,该主体包括设置在用于与相邻的椎骨节段或终板(其在图1中示出)接触的外表面上的涂覆有羟基磷灰石的表面。 [0006] Traditional interbody fusion (spine cage), or wherein the implant is generally kidney bean-shaped body, the body comprising a disposed adjacent vertebral endplate, or (which is shown in FIG. 1 ) coated on the outer surface of the contact surface of the hydroxyapatite. 具有平坦的终板的传统椎间融合器通常在试用植入物产生路径之后从后外侧靠近撑开的脊椎(distracted spine)的神经孔(neuroforamen)被插入。 The cage having a conventional planar endplate typically inserted close to the distraction of the spine (distracted spine) of the neural foramina (neuroforamen) from the outside of the implant after the trial generation path. 可选地,将两个平行的外部螺纹导管从前方插入以实现腰椎融合术。 Alternatively, the external threads of the catheter to enable insertion of two parallel lumbar fusion from the front. 植入物通常具有恒定的直径,而L5-S1椎间盘空间是梯形的,因此可能医源性地产生“平背(flat back) ”综合征。 The implant typically has a constant diameter, and the L5-S1 disc space is trapezoidal, and therefore may produce a "flat back (flat back)" to iatrogenic syndrome. 一般来说,椎间盘植入物用于腰椎融合或颈椎运动保持,而单独的杆和螺杆系统校正对齐。 Generally, intervertebral disc implant for cervical or lumbar fusion holding movement, and the screw rod and a separate alignment system calibration.

[0007] 对于本文公开的新型UEC,另外的选择包括整个脊柱的融合以及畸形角度校正(deformity angular correction)〇 [0007] For new UEC disclosed herein, further comprising selecting the angle of the entire spine fusion and correction of deformity (deformity angular correction) square

[0008] 用于椎间体稳定(interbody stabilization)的现有设备具有重要的且显著的局限性。 Existing equipment [0008] for stably intervertebral (interbody stabilization) have an important and significant limitations. 这些局限性中包括无法对终板进行扩张和撑开。 These limitations include endplates can not be expanded and softened. 因此,如果所插入的融合器“过小”, 则其可能“晃动并永不愈合”。 Thus, if the inserted cage "too small", it may "shake and never heal." 如果静态融合器过大,则可能通过终板的切除或沉陷而损伤邻近的神经或使脊柱不稳定。 If the static fusion is too large, and may cause damage to the adjacent nerves or spinal instability endplates by cutting or subsidence.

[0009] 目前用于椎间体稳定的设备包括静态隔离件,该静态隔离件由钛、PEEK、和由VICTREX (Victrex USA Inc,3A Caledon Court,Greenville,SC29615)生产的高性能热塑性聚合物、碳纤维或可吸收聚合物组成。 [0009] The present apparatus for stabilizing the intervertebral spacer comprises a static member, the static separator made of titanium, PEEK, and the VICTREX (Victrex USA Inc, 3A Caledon Court, Greenville, SC29615) production of high performance thermoplastic polymers, carbon fiber or resorbable polymer. 目前的椎间体隔离件无法保持椎间体脊柱前凸, 并且可能促使直的或甚至后凸的节段的形成,并且带来“平背综合征”的临床问题。 Currently intervertebral body spacer can not maintain interbody lordosis and may promote the formation of straight segments or even kyphosis, and bring clinical problem "flatback syndrome". 终板的分离增加了可用于神经元(特别是神经孔)的空间。 Separating the endplates may be used to increase the neuron (in particular neural foramen) space. 现有的静态融合器不能可靠地提升用于神经元的空间。 Existing static cages do not reliably improve the space for neurons. 因此,需要一种扩张融合器,其将从后部增加椎骨体之间的用于神经元的空间,或至少保持天然骨骼轮廓以避免神经失用(神经牵张)或侵入。 Therefore, a cage expansion, which will increase the space for the rear of neurons between vertebral bodies, or at least to avoid the natural contour of the bone neurapraxia (nerve stretch) or invasion.

[0010] 2006年9 月26 日提交的题为“Se I ecti ve I y Expand ing Sp i ne Cage, Hydraulically Controllable in Three Dimensions for Enhanced Spinal Fusion”的第7,985,256号美国专利,和2007年10月31日提交的题为“Linearly expanding spine cage for enhanced spinal fusion”的第7,819,921号美国专利,均提供了扩张椎间融合器(expanding spine cage)的详细背景。 [0010] "Se I ecti ve I y Expand ing Sp i ne Cage, Hydraulically Controllable in Three Dimensions for Enhanced Spinal Fusion" No. 7,985,256, entitled 2006 September 26 filed US patents, and October 31, 2007 filed entitled "Linearly expanding spine cage for enhanced spinal fusion" of US Patent No. 7,819,921, have provided detailed background expansion interbody fusion (expanding spine cage) in.

[0011] 上述第7,985,256号美国专利中公开的融合器仅限于与液压装置和腰椎融合一起使用。 [0011] The fusion No. 7,985,256 is disclosed in U.S. Patent fused limited to use with hydraulic means and lumbar. 第7,819,921号美国专利中公开的融合器允许梯形线性扩张,而不是均匀扩张,因此其中所公开的梯形L5融合器将保持自然的腰椎前凸。 No. 7,819,921 U.S. Patent Publication fusion allows trapezoidal linear expansion, the expansion is not uniform, so the cage trapezoidal L5 disclosed therein will maintain the natural lumbar lordosis. 所公开的融合器从未开发过。 The disclosed fusion was never developed. 其旨在用作向前插入以用于腰椎融合的两个(2)平行的线性扩张的分离导管。 Used as an insert which is intended for lumbar fusion forward to two (2) linear expansion in the separation conduit parallel.

[0012] 相比之下,本文公开的UEC融合器均匀地扩张,或在近端侧或远端侧处扩张。 [0012] In contrast, the herein disclosed fusion UEC uniformly expanded, or expanded at the proximal side or the distal side. 在有调节选项的情况下,外科医生可以使用新型UEC来矫正角度畸形。 In the case where an adjustment options, the surgeon may use to correct angular deformity new UEC.

[0013] 椎间体稳定的传统设备的另外的问题包括骨骼和生物材料之间不良接面(interface)。 [0013] Another problem of the conventional stabilized interbody device including poor junction between the bone and the biological material (interface). 传统的静态椎间体隔离件在骨骼和生物材料之间形成弱的接面。 Traditional static interbody spacer between the bone and the formation of biological material weak junction. 尽管这种植入物的表面通常设置有一系列脊或涂覆有羟基磷灰石,脊可以与施加的水平向量平行或并排运动。 Although this surface of the implant is generally provided with a series of ridges or coated with hydroxyapatite, the ridges may be parallel or side by side with the horizontal motion vector is applied. 也就是说,脊或涂层对于施加到终板的任一侧的移动提供很少的阻力。 That is, the ridges or coating provides little resistance to movement of either side is applied to the end plate. 因此,由于植入物和宿主骨之间的运动,在同种异体移植物、钛和聚合物隔离件中普遍出现骨不连合。 Accordingly, since the implant and the motion between host bone, allograft, titanium and polymer spacer member prevalence nonunion. 传统的设备通常不会在相邻的椎骨之间扩张。 Conventional devices often do not expand between adjacent vertebrae. 由于UEC在外科医生的控制下扩张,因此可视的、可触知的“适配度”设置可以在手术时理想地锁定相对的椎骨终板。 Since UEC expansion under control of the surgeon, and therefore visible, palpable "goodness of fit" can be provided over the locking opposing vertebral endplates during surgery. 随着愈合的产生,植入物变得无效。 With the emergence of healing, the implant becomes invalid. 由于没有运动可视为没有痛苦,因此使用UEC改善了临床结果。 Since there is no movement can be seen as no pain, so use UEC improved clinical outcomes.

[0014] 因此,需要提供一种扩张植入物的方法以改善即时固定力,该即时固定力可以超过在愈合时的最终强度,同时具有改善的能力,以在矫正椎间角度畸形的同时实现椎间盘空间固定一致性。 [0014] Accordingly, a need to provide a method to improve the expandable implant immediate fixing force fixing force which instant may exceed the ultimate strength during healing, while having an improved ability to correct the deformity while achieving intervertebral angles fixed disc space consistency. 这种可扩张植入物将理想地最大化接面的稳定性并增强稳定的固定。 Such expandable implant maximize stability over the surface thereof and enhance the stability of fixation. 这种可扩张椎间体植入物的即时固定将有利地提供与愈合时所实现的稳定性类似的稳定性。 Such expandable interbody implant immediate fixation will advantageously provide similar stability achieved when healing stability. 这种植入物将具有加强患者早期术后康复的价值。 Such implants would have strengthened the value of early postoperative rehabilitation of patients.

[0015] 传统的椎间体隔离件的另外的问题是其大的直径需要大面积暴露。 [0015] Another problem of the conventional intervertebral spacer body is its larger diameter requires a large exposure area. 用于椎间体隔离件的现有设备包括结构性同种异体移植物、带螺纹的融合器、圆柱形融合器和回旋镖形融合器。 Existing apparatus for interbody spacer comprising structural allografts cage a threaded cylindrical fusion cage and a boomerang shape. 传统的设备在安全性和有效性方面具有显着的限制性。 Conventional apparatus having a significant restriction in terms of safety and efficacy. 关于椎间体隔离件的安全性,将其从前部或从后部放置的方案可能发生神经元或主动脉元的损伤。 About Security interbody spacer, which is placed from the front or rear of the program may be damaged neurons or aortic membered occur. 传统的椎间融合器缺少扩张以降低了其固定性能的能力。 It lacks a conventional cage expands to its ability to reduce the fixing performance. 保护腰椎运动的先前尝试因在植入之后挤压植入物而失败了。 Previous attempts to protect the lumbar motion due to compression of the implant after implantation and failed. 神经元的风险主要是由于在为了充分地支撑椎间体空间所需的融合器的大的尺寸和可用于插入设备的小的空间之间的不一致所造成的,在从后部或经椎间孔入路放置时尤其如此。 Risk neurons mainly due to the inconsistency between the order to sufficiently support the desired spatial interbody fusion of large size and the small space available for insertion of the device caused by, or from the rear through the interspinous particularly when the hole is placed into the passage. 现有的回旋镖式融合器定形成部分地类似于扁平的菜豆。 Boomerang-type conventional fusion device are shaped like a flat part bean. 这种回旋镖式融合器的植入需要大面积的暴露且可能损伤血管和神经结构,这既因为该融合器无法进入时较小并变得更大,也归因于该融合器的插入需要在植入物的插入和扩张期间进行机械操作。 This boomerang-style fusion implants require a large area of ​​exposed and may damage the blood vessels and nerve structures, both because it is small and can not enter the cage becomes larger, but also due to the insertion of the fusion device needs mechanical operation during insertion and expansion of the implant. 一旦目前的回旋镖式植入物准备借助于试用隔离件插入以形成朝向前部脊柱的路径,则现有的静态融合器被推动朝向端点,从而期望其将到达期望的解剖学终点。 Once the current boomerang trial implant was prepared by means of a separator insertion portion to form a path toward the front of the spine, the conventional static cage is pushed towards the end, so it is desirable to reach a desired anatomical endpoints. 在神经根和血管结构接近插入位点并且传统的设备具有实心的相对大的尺寸的情况下,这种限制使患者易受到椎间孔(神经通过位点)侵入以及可能的神经和血管损伤的影响。 In the case of vascular structures close to the nerve roots and the insertion site and the conventional apparatus having a relatively large size of the solid, which limits the patient susceptible to foraminal (nerve by site) invasion and possible damage nerves and blood vessels influences.

[0016] 因此,需要一种微创性扩张椎间融合器,其能够以最小的侵入性插入到较小的开口(aperture)中。 [0016] Accordingly, a need for an expansion of minimally invasive intervertebral cage that can be inserted into the small opening (Aperture) with minimum invasive. 这样的微创性椎间融合器有利地可在三维空间中在完全位置控制或调节的情况下扩张。 Such minimally invasive interbody fusion advantageously expandable in full control or regulation of the position in three-dimensional space. 还需要一种较小的扩张椎间融合器,与对椎骨区域的限制空间中的神经根产生不必要的创伤的传统的相对大的设备相比,该较小的扩张椎间融合器更容易地以最小的手术创伤操作地插入到患者中。 Is also a need for a smaller expansion interbody fusion, a relatively large compared with the conventional apparatus unnecessary trauma to the nerve root space constraints vertebrae region of the smaller expansion of the cage are easier to inserted into the patient with minimal surgical trauma operatively. 现有的椎间体植入物具有可用于骨移植物的有限的空间。 Conventional intervertebral implants having limited space available for a bone graft. 足够的骨移植物或骨移植物替代物对于实心的椎间体融合术是至关重要的。 Adequate bone graft or bone graft substitutes for solid interbody fusion is essential. 期望提供一种可扩张椎间体融合器,其允许将大体积的骨移植材料放置在融合器内并围绕在其周围,以填充椎骨间的空间。 Desirable to provide an expandable intervertebral fusion device, which allows a large volume of bone graft material placed inside the cage and around its periphery to fill the space between the vertebrae. 此外,传统的椎间体植入物缺乏彻底地稳定终板并防止其移动的能力。 Moreover, conventional intervertebral body implant lacking completely stable endplates and prevent its ability to move. 因此,还需要一种扩张椎间融合器,其中椎骨终板经受将其撑开并阻止其移动的力。 Thus, a need for further expansion of the cage, wherein the vertebral endplates and softened is subjected to a force against movement. 这种椎间体融合器将能够稳定运动节段,从而减少微运动,并阻止假性关节的形成(不完全融合)和疼痛。 This interbody fusion device will be able to stabilize the motion segment, thereby reducing the micro-motion, and prevent the formation of pseudo-joints (incomplete fusion) and pain.

[0017] 理想地,需要一种椎间融合器或植入物,其能够使其在高度和角度上的扩张增加到所预计的程度。 [0017] Ideally, a need for an interbody fusion device or implant, which enable it to expand in height and angle is increased to the extent expected. 此外,需要一种椎间融合器,其不仅可以调节整个前后部扩张的量,还可以调节内外侧可变扩张,使得不仅保持了正常脊柱前凸曲线,还可以对脊柱侧凸或骨缺损进行调节。 Further, a need for an interbody fusion device, which not only can adjust the amount of the entire front portion dilated, may also be adjusted within a variable outer expansion, so that not only maintain the normal lordotic curve, may also be scoliosis or bone defects adjust. 这种椎间融合器或植入物将允许在手术之后恢复正常的脊柱对准,并将脊柱节段刚性地、机械地保持在一起,直到发生愈合。 Such interbody fusion implant will allow recovery or normal alignment of the spine after surgery and spinal segment is rigidly, mechanically held together, until healing occurs.

[0018] 还需要一种扩张融合器或植入物,其能够以增加的拉出强度保持椎骨或关节节段,以最小化在植入物结合到关节融合术骨块中期间植入物固定损失的可能性。 [0018] is also a need for an expandable fusion device or implant, which can increase the pull-out strength retaining vertebrae or joint segments, to minimize incorporated into the implant during implantation of bone arthrodesis of immobilized the possibility of loss.

[0019] 公开概述 [0019] SUMMARY OF THE DISCLOSURE

[0020] 根据本公开的一些方面,可扩张医疗植入物设置有具有近侧端和远侧端的可植入融合器主体。 [0020] According to some aspects of the present disclosure, an expandable medical implant is provided having a proximal end and a distal end of the implantable body fusion. 在一些实施方案中,融合器主体的近侧端和远侧端各自设置有锥形或凸轮部分。 In some embodiments, a proximal end and a distal end of the cage body are each provided with a cam or a tapered portion. 融合器主体还具有在融合器主体的近侧端和远侧端之间延伸的纵向轴线。 Fusion body further having a longitudinal axis between the proximal and distal ends extending cage body. 植入物还可以包括至少一个近侧弯曲部,该至少一个近侧弯曲部至少部分地定位成邻近融合器主体的近侧端并且配置为允许融合器主体的远侧端的周缘弹性地扩张。 The implant may further comprise at least one curved proximal portion, at least a proximal portion bent at least partially located adjacent the proximal end of the cage body and configured to allow the distal end of the cage body is elastically expandable periphery. 植入物还可以包括至少一个远侧弯曲部,该至少一个远侧弯曲部至少部分地定位成邻近融合器主体的远侧端并且配置为允许融合器主体的近侧端的周缘弹性地扩张。 The implant may further comprise at least one curved distal portion, curved distal portion of the at least one at least partially located adjacent the distal end of the cage body and configured to elastically expandable periphery of the cage to allow the proximal end of the body. 植入物还可以包括近侧塞构件,该近侧塞构件具有配置为与融合器主体的近侧端的锥形部分相配合的锥形部分。 The implant may further include a proximal plug member, the plug member has a tapered proximal tapered portion of the proximal end portion configured to mate with the body of the cage. 近侧塞构件可以配置为相对于融合器主体从第一位置纵向地移动到第二位置,使得至少一个远侧弯曲部移动并且融合器主体的近侧端的周缘弹性地扩张。 The proximal plug member may be configured with respect to the cage body moves longitudinally from a first position to a second position, such that the at least one curved distal portion and the proximal end of the movement of the cage body is elastically expandable periphery. 近侧塞构件还可以配置为从第二位置移动到第一位置,使得近侧端的周缘弹性地收缩。 The proximal plug member may also be configured to move from the second position to the first position, so that the peripheral edge of the proximal end of elastically shrinking. 植入物还可以包括远侧塞构件,该远侧塞构件具有配置为与融合器主体的远侧端的锥形部分相配合的锥形部分。 The implant may further include a distal plug member, the plug member has a tapered distal tapered portion of the distal end portion configured to mate with the body of the cage. 远侧塞构件可以配置为相对于融合器主体从第三位置纵向地移动到第四位置,使得至少一个近侧弯曲部移动并且融合器主体的远侧端的周缘弹性地扩张。 The distal plug member may be configured to move relative to the cage body longitudinally from the third position to the fourth position, such that movement of the at least one proximal and the distal end of the bent portion of the peripheral edge of the cage body is elastically expanded. 远侧塞构件还可以配置为从第四位置移动到第三位置,使得远侧端的周缘弹性地收缩。 The distal plug member may also be configured from the fourth position to the third position, such that the peripheral edge of the distal end of the elastically contracted.

[0021] 在一些实施方案中,融合器主体还包括在近侧端处的第一锥形钻孔和在远侧端处的第二锥形钻孔,第一锥形钻孔配置为可滑动地接纳近侧塞构件,第二锥形钻孔配置为可滑动地接纳远侧塞构件。 [0021] In some embodiments, the fusion body further comprises a tapered bore in a first proximal end and a distal end of the second tapered bore at the first tapered bore configured to slidably receive a proximal plug member, a second tapered bore configured to slidably receive a distal plug member. 第一锥形钻孔可以与近侧塞构件可螺纹地接合,使得当近侧端塞构件相对于融合器主体旋转时,近侧塞构件相对于融合器主体沿着纵向方向前进。 A first tapered bore may be engaged with the proximal threaded plug member, the plug member so that when the proximal end is rotated relative to the cage body, the plug member relative to the proximal body fusion proceeds along the longitudinal direction. 第二锥形钻孔可以与远侧塞构件可螺纹地接合,使得当远侧塞构件相对于融合器主体旋转时,远侧塞构件相对于融合器主体沿着纵向方向前进。 The second tapered bore may be engaged with a distal threaded plug member, the plug member so that when the distal cage is rotated relative to the body, the plug member with respect to the distal body fusion proceeds along the longitudinal direction.

[0022] 在一些实施方案中,至少一个近侧弯曲部包括大体上圆形的且端部开放的开口和从该开口纵向地延伸的一对大体上柔韧的梁部分。 [0022] In some embodiments, the at least one proximal portion comprises a curved end portion and a generally circular opening and open the opening extending longitudinally from a pair of substantially flexible beam portions. 至少一个近侧弯曲部包括一对纵向延伸的梁部分,该对纵向延伸的梁部分被纵向延伸的间隙间隔开,其中至少一个近侧弯曲部还包括将梁部分的近侧端相互连接起来的连接器部分。 At least one proximal portion includes a pair of curved longitudinally extending beam portion, the gap portion of the longitudinal beam extending longitudinally extending spaced apart, wherein the at least one proximal portion further includes a curved connecting portion of the proximal end of each beam connector portion. 至少一个近侧弯曲部可以包括多个周向间隔开的近侧弯曲部,并且其中至少一个远侧弯曲部包括多个周向间隔开的远侧弯曲部。 At least one proximal bend portion may include a plurality of circumferential spaced apart proximal curved portion, and wherein at least a distal portion comprising a distal bending portion bent a plurality of circumferentially spaced apart. 该多个近侧弯曲部可以与该多个远侧弯曲部旋转地交错。 The plurality of curved proximal portion rotatably distal interleaved with the plurality of bent portions.

[0023] 在一些实施方案中,每个近侧弯曲部包括一对纵向延伸的梁部分,该对纵向延伸的梁部分被纵向延伸的间隙间隔开并且通过连接器部分桥接在一起,该连接器部分仅将梁部分的近侧端相互连接起来。 [0023] In some embodiments, each of the proximal curved portion includes a pair of longitudinally extending beam portion, the gap portion of the longitudinal beam extending longitudinally extending spaced apart and connected by a bridging portion together, the connector the only part of the proximal end portion of the beam connected to each other. 每个远侧弯曲部可以包括一对纵向延伸的梁部分,该对纵向延伸的梁部分被纵向延伸的间隙间隔开并且通过连接器部分桥接在一起,该连接器部分仅将梁部分的远侧端相互连接起来。 The distal portion of each curved portion may include a pair of longitudinally extending beams, which are spaced apart pair of longitudinally extending gap beam portion extending longitudinally through the connector portion and bridged together, the distal connector portion only beam portions ends connected to each other. 每个近侧弯曲部可以与邻近每个近侧弯曲部的两个远侧弯曲部共享梁部分,从而允许沿着融合器主体形成连续的蛇形图案。 The proximal portion of each curved portion of the beam can be shared with each of two adjacent curved portions of the distal portion of the proximal bend, to allow the formation of a continuous serpentine pattern along the cage body.

[0024] 在一些实施方案中,植入物包括第一调节构件,该第一调节构件联接到至少近侧塞构件,使得当第一调节构件旋转时,使近侧塞构件纵向地移动。 [0024] In some embodiments, the implant comprising a first adjustment member, the first adjustment member is coupled to at least a proximal plug member, such that when the first adjustment member is rotated, so that the plug member is moved longitudinally proximally. 植入物还可以包括第二调节构件,该第二调节构件联接到远侧塞构件,使得当第二调节构件旋转时,使远侧塞构件纵向地移动,从而允许融合器主体的近侧端和远侧端彼此独立地扩张和收缩。 The implant may further comprise a second adjustment member, the second adjusting member is coupled to the distal plug member, such that when the second adjustment member is rotated, the distal plug member is moved longitudinally, allowing the proximal end of the cage body and a distal end expansion and contraction independently of each other. 第一调节构件和第二调节构件可以同轴地一个嵌套在另一个中并可独立地旋转。 A first regulating member and the second regulating member may be coaxially nested rotate independently and the other. 在一些实施方案中,第一调节构件和第二调节构件各自具有轴向间隔开但彼此相邻的旋钮,使得旋钮可以交替地一起旋转或独立地旋转。 In some embodiments, the first regulating member and the second regulating member each having axially spaced but adjacent to each knob can be rotated so that the knob rotate together or independently alternately. 第一调节构件和第二调节构件中的至少一个可以具有键式端部, 该键式端部配置为与其所关联的塞构件可滑动地配合且可旋转地联接,使得至少一个调节构件可以从可扩张医疗植入物移除。 A first regulating member and the second regulating member may have at least a portion of an end button, the button end portion configured to be its associated plug member fitted slidably and rotatably coupled, such that the at least one adjusting member from an expandable medical implants removed.

[0025] 在一些实施方案中,融合器主体具有横向于纵向轴线的方形或圆形横截面。 [0025] In some embodiments, the fusion body having a square or circular transverse cross-section of the longitudinal axis.

[0026] 在一些实施方案中,可扩张医疗植入物包括可植入融合器、多个近侧弯曲部、多个远侧弯曲部、近侧塞构件、远侧塞构件以及第一调节构件和第二调节构件。 [0026] In some embodiments, the expandable medical implant comprises an implantable fusion devices, the proximal plurality of curved portions, the plurality of curved distal portion, the proximal plug member, the plug member and the first distal regulating member and a second adjusting member. 在这些实施方案中,可植入融合器主体具有近侧端和远侧端,该近侧端和远侧端各自设置有带螺纹的且锥形的钻孔。 In these embodiments, the implantable cage body having a proximal end and a distal end, the proximal and distal ends each provided with a threaded bore and tapered. 融合器主体具有在融合器主体的近侧端和远侧端之间延伸的纵向轴线。 Cage body having a longitudinal axis between the proximal and distal ends extending cage body. 多个近侧弯曲部周向间隔开,并且各自至少部分地定位成邻近融合器主体的近侧端且配置为允许融合器主体的远侧端的周缘弹性地扩张。 The proximal plurality of circumferentially spaced curved portions, and are each at least partially positioned adjacent to the proximal end of the cage body and configured to allow the peripheral edge of the elastic body of the distal end of the cage expansion. 每个近侧弯曲部包括一对纵向延伸的梁部分,该对纵向延伸的梁部分被纵向延伸的间隙间隔开并且通过连接器部分桥接在一起,该连接器部分仅将梁部分的近侧端相互连接起来。 The proximal portion of each curved portion includes a pair of longitudinally extending beams, which are spaced apart pair of longitudinally extending gap beam portion extending longitudinally through the connector portion and bridged together, only the portion of the connector portion of a proximal end of the beam connected to each other. 多个远侧弯曲部周向间隔开,并且各自至少部分地定位成邻近融合器主体的远侧端且配置为允许融合器主体的近侧端的周缘弹性地扩张。 A distal plurality of circumferentially spaced curved portions, and are each at least partially positioned adjacent to a distal end of the cage body and is elastically expandable periphery arranged to allow the fusion of the proximal end of the body. 每个远侧弯曲部包括一对纵向延伸的梁部分,该对纵向延伸的梁部分被纵向延伸的间隙间隔开并且通过连接器部分桥接在一起,该连接器部分仅将梁部分的远侧端相互连接起来。 The distal portion of each curved portion includes a pair of longitudinally extending beams, which are spaced apart pair of longitudinally extending gap beam portion extending longitudinally through the connector portion and bridged together, only the portion of the connector portion of the distal end of the beam connected to each other. 每个近侧弯曲部与邻近每个近侧弯曲部的两个远侧弯曲部共享梁部分,从而沿着融合器主体形成连续的蛇形图案。 The proximal portion of each curved beam portions shared with each of two adjacent curved portions of the distal portion of the proximal bend, to form a continuous serpentine pattern along the cage body. 近侧塞构件具有带螺纹的且锥形的周缘,该周缘配置为与融合器主体的近侧端的带螺纹的且锥形的钻孔相配合。 The proximal plug member having a threaded periphery and tapered configuration of the periphery of threaded fusion with the proximal end of the body and cooperating tapered bore. 近侧塞构件配置为相对于融合器主体沿着纵向轴线从第一位置移动到第二位置,使得多个远侧弯曲部移动并且融合器主体的近侧端的周缘弹性地扩张。 Plug member disposed proximal relative to the cage body moves from the first position to the second position along the longitudinal axis, such that the plurality of curved distal portion and the proximal end of the movement of the cage body is elastically expandable periphery. 近侧塞构件还配置为从第二位置移动到第一位置,使得近侧端的周缘弹性地收缩。 The proximal plug member further configured to move from a first position to a second position, such that the peripheral edge of the proximal end of the elastically contracted. 远侧塞构件具有带螺纹的且锥形的周缘,该周缘配置为与融合器主体的远侧端的带螺纹的且锥形的钻孔相配合。 The distal plug member having a threaded periphery and tapered configuration of the peripheral edge of the distal threaded end of the cage body and cooperating tapered bore. 远侧塞构件配置为相对于融合器主体沿着纵向轴线从第三位置移动到第四位置,使得多个近侧弯曲部移动并且融合器主体的远侧端的周缘弹性地扩张。 The distal plug member is configured to move relative to the cage body from the third position to the fourth position along the longitudinal axis, such that movement of the plurality of proximal and distal portions bent end periphery of the cage body is elastically expanded. 远侧塞构件还配置为从第四位置移动到第三位置,使得远侧端的周缘弹性地收缩。 The distal plug member is further configured to move from the fourth position to the third position, such that the peripheral edge of the distal end of the elastically contracted. 第一调节构件可旋转地联接到近侧塞构件,使得当第一调节构件旋转时,使近侧塞构件沿着纵向轴线移动。 The first adjustment member is rotatably coupled to a proximal plug member, such that when the first adjustment member is rotated, so that the plug member is moved proximally along the longitudinal axis. 第二调节构件可旋转地联接到远侧塞构件,使得当第二调节构件旋转时, 使远侧塞构件纵向地移动,从而允许融合器主体的近侧端和远侧端彼此独立地扩张和收缩。 The second adjustment member is rotatably coupled to the distal plug member, such that when the second adjustment member is rotated, the distal plug member is moved longitudinally, so as to allow a proximal end and a distal end of the cage body to expand independently of each other and shrink. 第一调节构件和第二调节构件同轴地一个嵌套在另一个中并且可独立地旋转。 A first adjustment member and a second regulating member coaxially and independently rotatable nested in the other. 第一调节构件和第二调节构件各自具有轴向间隔开但彼此相邻的旋钮,使得旋钮可以交替地一起旋转或独立地旋转。 A first regulating member and the second regulating member having axially spaced apart but each adjacent knobs, or independently so that the knob can be alternately rotated together. 第一调节构件和第二调节构件中的至少一个可以具有键式端部,该键式端部配置为与其所关联的塞构件可滑动地配合且可旋转地联接,使得至少一个调节构件可以从可扩张医疗植入物移除。 A first regulating member and the second regulating member may have at least a portion of an end button, the button end portion configured to be its associated plug member fitted slidably and rotatably coupled, such that the at least one adjusting member from an expandable medical implants removed.

[0027] 根据本公开的一些方面,提供了一种撑开具有相对表面的相邻骨节段的方法。 [0027] According to some aspects of the present disclosure, there is provided a method for the expansion of adjacent bone segments having opposing surfaces. 该方法包括以下步骤:将上述可扩张医疗植入物插入到骨节段的相对表面之间,以及使近侧塞构件和远侧塞构件纵向地且彼此独立地移动,使得融合器主体的近侧端和远侧端独立地扩张,以改变骨节段的相对的表面之间的距离和角度。 The method comprises the steps of: the above-described expandable medical implant is inserted between the opposing surfaces of the bone segments, and causing the proximal and distal plug member and the plug member longitudinally independently of one another, such that the proximal cage body and distal ends expand independently to vary the distance and the angle between the opposing surfaces of the bone segments. 在一些实施方案中,该方法还包括以下步骤:在调节构件已经用于移动近侧塞构件和远侧塞构件中的至少一个之后,从医疗植入物移除至少一个调节构件。 In some embodiments, the method further comprising the steps of: adjusting member has a plug member for moving the proximal and distal plug member after at least one, at least one adjusting member is removed from the medical implant. 在一些实施方案中,骨节段是相邻的椎骨,并且相对的表面是相邻椎骨的终板。 In some embodiments, the bone segments are adjacent vertebrae, and a surface opposite to the end plates of adjacent vertebrae.

[0028] 附图简述 [0028] BRIEF DESCRIPTION

[0029] 为了说明本公开的概念,附图示出一个或更多个实施方案的方面。 [0029] To illustrate the concepts of the present disclosure, the drawings illustrate one or more aspects of the embodiments. 然而,应当理解,本公开不限于在附图中所示的精确布置和手段,其中: However, it should be understood that the present disclosure is not limited to the precise arrangements and instrumentalities shown in the drawings, wherein:

[0030] 图1-3是两个椎骨体的一系列侧向表示,其中,图1示出了处于未扩张状态的示例性通用扩张融合器(UEC)的插入,图2示出了UEC在椎骨体之间的位置并且仍处于其未扩张状态,且图3示出了已插入的处于扩张状态的UEC。 [0030] Figures 1-3 are a series of laterally two vertebral bodies, where, in FIG. 1 illustrates an exemplary unexpanded expandable universal cage (UEC) is inserted, FIG. 2 shows in UEC a position between the vertebral bodies and is still in its unexpanded state, and FIG. 3 shows a UEC in the expanded state inserted.

[0031] 图4是根据本公开的方面的处于未扩张状态的UEC的第一实施方案的透视图。 [0031] FIG. 4 is a perspective view of a first embodiment of the present embodiment UEC aspects of the disclosure in the unexpanded state.

[0032] 图5是示出图4的UEC的分解透视图。 [0032] FIG. 5 is an exploded perspective view of FIG. 4 UEC FIG.

[0033] 图6是示出图4的UEC的融合器主体的透视图。 [0033] FIG. 6 is a perspective view showing the cage body UEC FIG. 4.

[0034] 图7是图4的UEC的近侧端视图。 [0034] FIG 7 is a proximal end view of FIG. 4 UEC.

[0035] 图8是图4的UEC的侧视图。 [0035] FIG. 8 is a side view of FIG. 4 UEC.

[0036] 图9是图4的UEC的侧向剖视图。 [0036] FIG. 4 FIG. 9 is a side sectional view of the UEC.

[0037] 图10是根据本公开的方面的处于未扩张状态的UEC的第二实施方案的透视图。 [0037] FIG. 10 is a perspective view of a second embodiment of the aspect of the embodiment of the present disclosure UEC is in the unexpanded state.

[0038] 图11是示出图10的UEC的分解透视图。 [0038] FIG. 11 is an exploded perspective view of FIG. 10 UEC FIG.

[0039] 图12是示出图10的UEC的侧视图。 [0039] FIG. 12 is a side view of FIG. 10 UEC.

[0040] 图13是示出图10的UEC的近侧端视图。 [0040] FIG 13 is a proximal end view of the UEC 10 of FIG.

[0041] 图14是示出图10的UEC的远侧端视图。 [0041] FIG 14 is a distal end view of FIG. 10 UEC.

[0042] 图15是示出图10的UEC的侧向剖视图。 [0042] FIG UEC 15 is a side sectional view of FIG. 10 is shown.

[0043] 图16是根据本公开的方面的处于未扩张状态的UEC的第三实施方案的透视图。 [0043] FIG. 16 is a perspective view of a third embodiment of the aspect of the present embodiment UEC disclosure of unexpanded state.

[0044] 图17是示出图16的UEC的分解透视图。 [0044] FIG. 17 is an exploded perspective view of FIG. 16 UEC FIG.

[0045] 图18是示出图16的UEC的侧视图。 [0045] FIG. 18 is a side view of FIG. 16 the UEC.

[0046] 图19A是示出图16的UEC的侧向剖视图。 [0046] FIG. 19A is a lateral UEC FIG. 16 shows a cross-sectional view.

[0047] 图19B是示出图16的UEC的端部剖视图。 [0047] FIG. 19B is an end portion UEC FIG. 16 shows a cross-sectional view.

[0048] 图20A-20C是示出图16的UEC的逐渐扩张的一系列侧视图,其中图20A示出了UEC的两端都处于未扩张状态,图20B示出了仅一端已扩张,并且图20C示出了两端都已扩张。 [0048] Figures 20A-20C is a side view of a series of gradual expansion of the UEC shown in FIG. 16, FIG. 20A shows where UEC ends are in an unexpanded state, FIG. 20B shows only one end of the expanded, and 20C shows the ends are expanded.

[0049] 图21是根据本公开的方面的处于未扩张状态的UEC的第四实施方案的透视图。 [0049] FIG. 21 is a perspective view of a fourth embodiment according to aspects of the present embodiment UEC disclosure in the unexpanded state.

[0050] 图22是根据本公开的方面的处于未扩张状态的UEC的第五实施方案的透视图。 [0050] FIG. 22 is a perspective view of a fifth embodiment of the present aspect of the UEC disclosure of unexpanded state.

[0051] 图23是示出图22的UEC的远侧端视图。 [0051] FIG 23 is a distal end view of the UEC 22 of FIG.

[0052] 图24是示出图22的UEC的侧视图。 [0052] FIG. 24 is a side view UEC 22 of FIG.

[0053] 图25是示出图22的UEC的侧向剖视图。 [0053] FIG. 25 is a side cross-sectional view of the UEC 22 shown in FIG.

[0054] 图26是从颅骨至尾骨的视图,其示出了在一个示例性实施方式中的在椎骨体上的双重UEC的插入位点。 [0054] FIG. 26 is a view from the skull to the coccyx, which shows the insertion site In one exemplary embodiment of a double UEC in the vertebral body.

[0055] 图27是示出图26的实施方式的插入位点之一的斜后视图。 [0055] FIG. 27 is a rear oblique view of one embodiment of the embodiment shown in FIG. 26 of the insertion site.

[0056] 图28是示出由图26的实施方式提供的调节轴的斜后视图。 [0056] FIG. 28 is a rear view showing the swash axis adjustment provided by the embodiment of FIG. 26.

[0057] 图29是示出前柱植入物的斜前视图。 [0057] FIG. 29 is a front oblique view showing the front pillar of the implant.

[0058] 图30是示出显示为脊柱侧凸的人类脊柱的后视图。 [0058] FIG. 30 is a diagram showing a rear view of a human spinal scoliosis.

[0059] 图31是示出根据本公开的方面进行矫正之后的图29的脊柱的后视图。 [0059] FIG. 31 is a rear view of the spine is corrected in accordance with the following aspects of the present disclosure of FIG. 29.

[0060] 图32A-32C分别是示出了具有错位/不均匀间隔的相邻椎骨体的前视图、侧视图和斜视图。 [0060] FIGS. 32A-32C are shown having offset / uneven front view, side view and perspective view of adjacent vertebral bodies intervals.

[0061] 图33A-33C分别是示出了根据本公开的方面的已对错位/不均匀间隔进行矫正的图32A-32C的椎骨体的前视图、侧视图和斜视图。 [0061] FIGS. 33A-33C are diagrams illustrating a front view of the vertebral body 32A-32C, a side view and a perspective view of a pair is offset / interval unevenness correction aspects of the present disclosure of FIG.

[0062] 详细描述 [0062] Detailed Description

[0063] 参考图1-3,示出了椎骨节段50和52的一系列侧视图,该一系列侧视图描绘了UEC (通用扩张融合器)的一个实施方案的插入和扩张。 [0063] Referring to Figures 1-3, there is shown a side view of a series of vertebral segments 50 and 52, which depicts a side view of a series of insertion and expansion of the UEC (universal expandable cage) in one embodiment. 所示出的椎骨体50和52在椎骨终板之间具有平均8_的间隙,代表平均椎骨间空间54。 50 and having an average 8_ gap 52 between the vertebral endplates of the vertebral body shown, representative of the average inter-vertebral space 54. 在典型的实施方式中,在插入UEC56之前进行完全的椎间盘切除术。 In the exemplary embodiment, the complete discectomy prior to insertion UEC56. 利用标准技术移除占据空间54的椎间盘,标准技术包括修骨术(rongeur)、刮除术、以及对出血软骨下骨的终板制备。 Use standard techniques to remove the space occupied by the disc 54, standard techniques, including surgery to repair a bone (rongeur), curettage, and the prepared bone hemorrhage cartilaginous endplate. 后纵韧带被分开以允许椎骨间空间扩张。 Posterior longitudinal ligament are separated to allow expansion of the intervertebral space.

[0064] 可使用旋转刮刀(未示出)将椎骨间空间54撑开至约10mm。 [0064] can be used rotating blades (not shown) to the intervertebral space spreader 54 to about 10mm. 该旋转刮刀是一个众所周知的设备,其看起来像宽螺丝刀,该设备可以水平地置入椎间盘空间内并转动90度,以分离终板。 The rotating blade is a well known device, which looks like a wide screwdriver, the apparatus may be horizontally inserted within the disc space and rotated 90 degrees, to separate the endplate. UEC的一个新的特征是在椎间盘空间扩张和制备(通过刮除,或理想地通过有助于椎间盘材料移除的关节镜)之后,UEC植入物本身可以被插入穿过不会对神经或其他结构造成损伤的任何孔口或角度,被定位在即时的植入物位置和随后的扩张平台以产生最佳融合和角度矫正结果。 A new feature of the UEC are prepared in the intervertebral disc space and expandable (by scraping, or by contributing to desirably remove disc material arthroscopic) after, UEC implant itself can not be inserted through the nerve or any damage to the aperture angle or other structures, are positioned to produce the best fusion results in immediate and angular correction of the position of the implant and subsequent expansion of internet.

[0065] 在图1-3中所示的示例性实施方式中,UEC 56从后部(沿着箭头58的方向)被插入到椎骨体50和52之间,如图1所示。 [0065] In the exemplary embodiment shown in FIGS. 1-3, UEC 56 from the rear (direction of the arrow 58) is inserted between the vertebrae 50 and 52, as shown in FIG. 所示的椎骨空间54旨在表示希望插入UEC的任何椎骨空间(骶骨、腰椎、胸椎和/或颈椎),并且来自周围解剖体允许的任何方向。 Intervertebral space 54 shown is intended to mean any desirable to insert the intervertebral space UEC (sacral, lumbar, thoracic and / or cervical spine), and from any direction around the anatomy allowed. 根据本公开的一个方面,UEC在其未扩张状态下缩小到小的尺寸,以使其能够插入穿过到椎骨间空间54中,如图1所示。 According to one aspect of the present disclosure, the UEC reduction in its non-expanded state to a small size so that it can be inserted into the intervertebral space through 54, as shown in FIG. 图2示出了插入在椎骨体50和52之间的UEC 56,其中UEC 56仍处于未扩张状态。 Figure 2 shows a body is inserted between the vertebrae 50 and 52 UEC 56, wherein UEC 56 is still in the unexpanded state. 在一个示例性实施方案中,未扩张的UEC的尺寸为:l〇-12mm宽,IOmm高和28mm长,以便于插入, 从而最小化对患者的创伤和损伤神经根的风险。 In one exemplary embodiment, the unexpanded dimension of UEC: l〇-12mm wide, IOmm high and 28mm long, to facilitate insertion, thereby minimizing the risk of trauma to the patient and nerve root damage. 这些尺寸可以容纳平坦的外表面。 These dimensions can accommodate flat outer surface. 一旦就位,示例性UEC 56可以扩张到其未扩张尺寸的百分之140 (如图3所示),使得能够根据3D临床术前解剖分析进行20度或更多度的脊柱矫正。 Once in place, the exemplary UEC 56 may be expanded to 140 (FIG. 3) which percent unexpanded size, enabling correction of the spine 20 or more degrees before 3D analysis of anatomical clinical surgery.

[0066] 应当注意,虽然图1-3中示出的示例性UEC 56为旨在理想地填充获许空间的植入物,但还可以使用其他形状的植入物,如后面的附图中所示的和/或本文所述的那些。 [0066] Note that although Figures 1-3 shown an exemplary UEC 56 is intended to fill over the implant was allowed space, but other shapes may be used in implants, such as the following figures and / or those described herein illustrated. 在各种实施方案中,植入物可以具有圆形、卵形、椭圆形、方形、矩形、梯形或适于填充植入物位点并传递所需负载的其它形状的横截面。 In various embodiments, the implant may have a circular, oval, elliptical, square, rectangular, trapezoidal, or adapted to fill the implant site and transmitting other cross-sectional shapes of the required load. 植入物可以是直的、弯曲的、豆形的、和/或包括其它形状和长宽比。 The implant may be straight, curved, bean-shaped, and / or include other shapes and aspect ratio. 另外,外表面可以是光滑的、带尖的、有螺纹的、涂覆的和/或另外适配的, 如稍后更详细描述的。 Further, the outer surface may be smooth, with a pointed, threaded, coated and / or otherwise adapted, as described in more detail later. UEC可以在外科医生认为需要进行融合的任何脊柱水平(spinal level)处使用,并且可以根据需要相对于椎骨终板放置在任何位置和角度。 UEC regarded that any required level spinal fusion (spinal level) at use, and the surgeon may be required with respect to the vertebral end plates are placed at any position and angle. 可以在任何特定的水平处放置一个、两个或更多个UEC以实现椎骨体之间的期望高度和角度。 A can be placed at any particular level, the two or more UEC to achieve the desired height and angle between the vertebral bodies. 如稍后将描述的,可以使用多个UEC来调节相邻的椎骨体之间的总头尾高度(overall cranio-caudal height)、前后角度(anterior-posterior angle)和内外侧角度(medio-lateral angle)。 As will be described later, you may be used to adjust the overall end to end a plurality of UEC height between adjacent vertebral bodies (overall cranio-caudal height), the front and rear angle (anterior-posterior angle) and the outer angle (medio-lateral angle). 可以在多个水平处植入UEC以获得或恢复脊柱的期望的三维曲率和定位。 UEC may be implanted at the level of the plurality of restoration of the spinal column or to obtain a desired three-dimensional curvature and positioning.

[0067] 参考图4-9,示出了根据本公开的方面的示例性UEC 100的第一实施方案。 [0067] Referring to FIG 4-9, there is shown a first embodiment 100 according to an exemplary embodiment UEC aspect of the present disclosure. 图4是示出UEC 100的细节的放大透视图。 FIG 4 is an enlarged perspective view showing a detail of the UEC 100. 为了便于理解,可以界定UEC100的近侧端104和远侧端106,如图4所示。 For ease of understanding, it may define a proximal end 104 and a distal end UEC100 106, as shown in FIG. 应当注意,虽然UEC 100的远侧端106通常首先插入到患者体内,并且近侧端104通常最接近外科医生,但在某些手术中可以采用该示例性设备和本文描述的其他设备的其他定向,尽管使用了远侧和近侧命名法。 It should be noted that, while the distal end 106 of UEC 100 is usually first inserted into a patient, and a proximal end 104 closest to the surgeon typically, in certain surgical devices may be another example of the apparatus described herein and employed other orientations and France despite the use of distal and proximal name.

[0068] 参考图5,其为示出UEC 100的单独的部件的分解透视图。 [0068] Referring to FIG 5, which is an exploded perspective view illustrating a separate member UEC 100 of FIG. 在该第一实施方案中, UEC 100包括圆柱形融合器主体108、近侧塞110、远侧塞112、带螺纹的致动器114和垫圈116。 In this first embodiment, UEC 100 includes a cylindrical cage body 108, the plug 110 proximal, distal plug 112, a threaded actuator 114 and a washer 116. 术语“塞”和“塞构件”在本文中可互换使用。 The term "plug" and "plug member" are used interchangeably herein. 致动器114具有柄,该柄定尺寸成当组装UEC 100时可滑动地穿过近侧塞110内的中心钻孔。 The actuator 114 has a shank sized to slidably pass through the central bore in the proximal plug 110 when assembled UEC 100. 致动器114在其远侧端上还具有螺纹以用于与远侧塞112内的带螺纹的中心钻孔接合。 Actuator 114 at the distal end thereof and further having a threaded distal plug for threaded central bore 112 in engagement. 近侧塞110和远侧塞112各自具有向内逐渐变小的外表面,以配合融合器主体108内的向内逐渐变小的表面(如图9中最佳看到的)。 The proximal plug 110 and distal plug 112 each having an inwardly tapering outer surface, inwardly to fit within the cage body 108 tapering surface (best seen in FIG. 9). 利用该布置,致动器114可以沿着第一方向旋转以将远侧塞112拉向近侧塞110,以使融合器主体108向外扩张,如稍后将更详细地描述的。 With this arrangement, the actuator 114 may be rotated to pull proximally the distal plug 112 along a first direction of the plug 110, the cage body 108 to cause outward expansion, as will be described in more detail later.

[0069] 参考图6,该透视图示出了UEC 100的第一示例性实施方案的融合器主体108的细节。 [0069] Referring to Figure 6, a perspective view illustrating a detail of the cage body UEC first exemplary embodiment 100 of 108. 在该实施方案中,融合器主体108包括八个纵向延伸的梁部分118,每个梁部分118与相邻的梁部分118通过纵向延伸的间隙120间隔开。 In this embodiment, the cage body 108 includes a beam portion 118 extending longitudinally eight, each beam section 118 and the gap portion adjacent to the longitudinally extending beams 118 through 120 are spaced apart. 在其它实施方案(未示出)中,融合器主体可以包括少于或多于八个梁部分和/或具有不同的或变化的横截面的梁部分。 In other embodiments (not shown), the cage body may comprise fewer or more than eight beam portions and / or portions of the beam cross section has different or varying. 当前实施方案的融合器主体108还包括八个周向延伸的连接器部分122。 Fusion to the current embodiment of the main body 108 further includes eight circumferentially extending connector portion 122. 连接器部分122将梁部分118的端部相互连接起来。 The connector portion 122 of the end portion of the beam portion 118 is connected to each other. 连接器部分122中的四个位于融合器主体108的近侧端104处,并且另外四个连接器部分122位于远侧端106处。 The connector portion 122 located at the proximal end of four cage 104 body 108, and four additional connector portion 122 located at a distal end 106. 位于近侧端104处的连接器部分122相对于位于远侧端106处的连接器部分122交错,使得每对相邻的梁部分118仅在一端处通过连接器部分122 连接。 End 104 of the connector 122 relative to the proximal portion 106 located at the distal end of the connector portion 122 are staggered such that each pair of adjacent beams only at a portion 118 connected by a connector portion 122 at one end. 利用这种布置,梁部分118和连接器部分122形成连续的蛇形或重复的S形图案。 With this arrangement, the beam portion 118 and the connector portion 122 to form a continuous serpentine or S-shaped repeating pattern. 梁部分118和/或连接器部分122配置为弹性地弯曲,以允许融合器主体108在被塞110和112径向向外推动时直径增加(如图4所示)。 Portion 118 and / or the connector portion 122 configured to elastically bend the beam to allow the cage body 108 when the plug 110 is pushed radially outwardly increased diameter and 112 (FIG. 4). 当塞110和112不径向地向外推动融合器主体108时,梁部分118和/或连接器部分122的弹性允许融合器主体108恢复到其初始减小的直径。 When the plugs 110 and 112 are not driven radially outwardly when the cage body 108, elastic portion 118 and / or connector 122 of the beam portion 108 allows the cage body to recover its initial reduced diameter. 可以理解,当梁部分118和/或连接器部分122向外弯曲时,间隙120在其与连接器部分122相对的开口端处变宽。 It will be appreciated, when the beam portion 118 and / or the connecting portion 122 is bent outwardly, and the gap 120 is widened at its end opposite the connector opening portion 122. 梁部分118的面向外的表面可以各自设置有如图所示的一个或更多个尖或尖状部123,以允许融合器主体108抓牢椎骨体的终板。 Facing surface of the outer beam portion 118 may each provide one or more sharp or pointed with a portion shown in FIG. 123, the cage body 108 to allow the gripping of the vertebral body endplates.

[0070] 参考图7,示出了UEC 100的近侧端104的端部视图。 [0070] Referring to Figure 7, there is shown an end view of the proximal end 104 UEC 100. 在致动器114的近侧端处的扩大的头部可以设置有如图所示的凹入插口124,该凹入插口124用于可移除地接纳用于转动致动器114的工具。 In the enlarged head at the proximal end of actuator 114 may be provided with a recessed socket 124 as shown in FIG., The recessed socket 124 for removably receiving the tool for actuation of the actuator 114 is rotated. 近侧塞110 (以及未示出的远侧塞112)可以设置有径向向外延伸的突出部126,该突出部126置于一个或更多个间隙120中并抵靠梁部分118的侧部。 Plug 110 in the proximal (and not distal plug 112 is shown) may be provided with a radially outwardly extending projection 126, the projection 126 is placed one or more gaps 120 and 118 against the side of the beam portion unit. 这种布置防止塞110和112在致动器114转动时旋转,从而约束塞110和112仅朝向或远离彼此轴向地移动。 This arrangement prevents rotation of the plug 110 and 112 when the actuator 114 is rotated, so that the plug 110 and constraints 112 only axially moved toward or away from each other. 近侧塞110(和远侧塞112)可以设置有通孔和或凹槽128,以允许骨骼从椎骨体向内生长,以用于使UEC 100更牢固的愈合/融合就位。 The proximal plug 110 (and the distal plug 112) may be provided with through holes or recesses 128 and to permit bone growth from vertebral body inwardly to UEC 100 for stronger healing / integration place. 还可以设置纵向延伸的狭槽130 (如图4所示)用于该目的,和或为了用自体移植物、同种异体移植物和/或用于促进愈合/融合的其他材料来装填塞110和112。 Other materials may also be provided a longitudinally extending slot 130 (FIG. 4) used for this purpose, and to use or autograft, allograft and / or for promoting healing / stuffer 110 fused to install and 112.

[0071] 参考图8和图9,分别示出了侧视图和侧向剖视图。 [0071] Referring to Figures 8 and 9, respectively, show a side view and lateral sectional view. 在操作中,通过将诸如内六角扳手或驱动器(未示出)的工具插入到致动器114的近侧端处的凹入插口124中并将其顺时针地转动来扩张UEC 100。 In operation, the driver or hex wrench, such as a (not shown) by inserting a tool into the recessed socket 124 at the proximal end of the actuator 114 and its rotation clockwise to expand UEC 100. 如图9最佳示出的,致动器114的远侧端旋入远侧塞112的中心钻孔中。 Best shown in FIG. 9, the distal end of the actuator 114 is screwed into the distal plug 112 of the central bore. 顺时针转动致动器114导致致动器114的远侧端将远侧塞112拉向融合器主体108的中心,同时致动器114的近侧端处的扩大的头部将近侧塞110推向该中心。 Clockwise rotation of the actuator 114 causes the distal end of the actuator 114 will pull the distal plug 112 toward the center of the cage body 108, while the enlarged head actuator at the proximal end of actuator 114 to push the proximal plug 110 to the Center. 这种移动进而导致塞110和112的倾斜表面132沿着沿梁部分118和连接器部分122的内侧定位的倾斜表面134 向内滑动,以使这些元件径向地向外弯曲和扩张,如之前所述的。 This movement in turn results in the plug 110 and the inclined surface 112 along the beam 132 along the inner side positioning portion 118 and the connector portion 122 slides inwardly inclined surface 134, so that these elements and expanded radially outwardly bent, as previously said. 通过逆时针转动致动器114可以使该过程颠倒过来。 By the counterclockwise rotation of the actuator 114 so that the process can be reversed. 抵抗塞110和112的来自梁部分118和或连接器部分122的向内的弹性力(和或来自相邻的椎骨体的压缩力)使两个塞轴向地分离,从而允许UEC 100恢复到其未扩张的状态。 And the plug 110 against the elastic force inward portion 122 (or the compression force and from the adjacent vertebral bodies) or from the connector portion 118 and the beam 112 of the two plugs axially separated, thus allowing to recover UEC 100 its non-expanded state.

[0072] 参考图10-15,示出了根据本公开的方面的示例性UEC 200的第二实施方案。 [0072] reference to Figures 10-15, there is shown a second embodiment 200 according to an exemplary embodiment UEC aspect of the present disclosure. 图10 是表示UEC 200的细节的透视图。 FIG 10 is a perspective view of the detail of the UEC 200. UEC 200包括近侧端204和远侧端206,并且共享先前所述的UEC 100的许多相同的特征,该相同的特征用类似的参考数字标识。 UEC 200 includes a proximal end 204 and a distal end 206, and shares many features UEC 100 previously described, the same features identified by like reference numerals.

[0073] 参考图11,其为示出了UEC 200的单独的部件的分解透视图。 [0073] Referring to FIG 11, which is shown an exploded perspective view of a single member of the UEC 200. 在该第二实施方案中,UEC 200包括细长的圆柱形融合器主体208、近侧塞210和远侧塞212。 In this second embodiment, UEC 200 comprises an elongated cylindrical cage body 208, a proximal plug 210 and distal plug 212. 远侧塞212包括一体形成的致动器杆214,当组装UEC 200时,致动器杆214沿着融合器主体208的内部中心轴线朝向近侧塞210延伸。 The distal plug 212 includes an integrally formed actuator rod 214, when assembled UEC 200, actuator rod 214 toward the stopper 210 extends proximally along the central axis 208 of the inner body fusion. 近侧塞210和远侧塞212各自具有带螺纹的且向内逐渐减小的外表面,以配合融合器主体208内的带螺纹的且向内逐渐变小的表面(如图15最佳示出的)。 The proximal plug 210 and distal plug 212 and the respective outer surface having a gradually decreasing inwardly threaded to a threaded fitting 208 within the cage body and inwardly tapering surface (15 best shown in FIG. out). 利用这种布置,每个塞210和212可以独立地旋转以使特定的塞朝向融合器主体208的中部轴向地移动,以使融合器主体208的特定端部204或206向外扩张,如稍后将更详细地描述的。 With this arrangement, each of the plugs 210 and 212 may be independently rotated to a particular orientation of the fusion plug body 208 moves axially middle, so that the cage body 204 of a particular end 208 or 206 to expand outwards, such as It will be described in detail later.

[0074] 如图11和图12所示的,融合器主体208包括八个纵向延伸的梁部分218,每个梁部分218与相邻的梁部分218被纵向延伸的间隙220间隔开。 [0074], the fusion body shown in FIG. 11 and 12 beam 208 includes eight longitudinally extending portion 218, each beam section 218 and the beam portion 218 is adjacent to a gap 220 extending longitudinally spaced apart. 在其它实施方案(未示出)中,融合器主体可以包括少于或多于八个梁部分和/或具有不同的或变化的横截面的梁部分。 In other embodiments (not shown), the cage body may comprise fewer or more than eight beam portions and / or portions of the beam cross section has different or varying. 当前实施方案的融合器主体208还包括八个周向延伸的连接器部分222。 Fusion to the current embodiment of the main body 208 further includes eight circumferentially extending connector portion 222. 连接器部分222将梁部分218的端部相互连接起来。 The connector portion 222 of the end portion of the beam portion 218 is connected to each other. 连接器部分222中的四个位于融合器主体208的近侧端204处, 并且另外四个连接器部分222位于远侧端206处。 The connector portion 222 of the fusion of the four body 208 at a proximal end 204, and four additional connector portion 222 located at a distal end 206. 位于近侧端204处的连接器部分222相对于位于远侧端206处的连接器部分222交错,使得每对相邻的梁部分218仅在一端处通过连接器部分222连接。 Located at the proximal end 204 relative to the connector portion 222 of the connector portion 222 at the distal end 206 of staggered, so that each pair of adjacent beams at only one end portion 218 connected by a connector portion 222. 利用这种布置,梁部分218和连接器部分222形成连续的蛇形或重复的S形图案。 With this arrangement, the beam portion 218 and connector portion 222 to form a continuous serpentine or S-shaped repeating pattern. 梁部分218和或连接器部分222配置为弹性地弯曲,以允许融合器主体208在被塞210 和212径向向外推动时直径增加。 Or beam portion 218 and connector portion 222 configured to be elastically bent to allow the body 208 increases the diameter of the cage when the plug 210 is pushed radially outward and 212. 当塞210和212不径向地向外推动融合器主体208时,梁部分218和或连接器部分222的弹性允许融合器主体208恢复到其初始减小的直径。 When the plug 210, and 212 are not driven radially outwardly when the cage body 208, elastic portion 218 and the beam portion 222 or the connector allows the cage body 208 to return to its initial reduced diameter. 可以理解, 当梁部分218和或连接器部分222向外弯曲时,间隙220在其与连接器部分222相对的开口端处变宽。 It will be appreciated, when the beam portion or the connection portion 218 and 222 is bent outward, and the gap 220 is widened at its end opposite the connector opening portion 222. 梁部分218的面向外的表面可以各自设置有如图所示的一个或更多个尖或尖状部223,以允许融合器主体208抓牢椎骨体的终板。 An outer surface facing the beam portion 218 may each be provided with one or more sharp or pointed with a portion shown in FIG. 223, the cage body 208 to allow the gripping of the vertebral body endplates.

[0075] 参考图13,示出了UEC 200的近侧端204的端部视图。 [0075] Referring to Figure 13, there is shown an end view of the proximal end 204 of the UEC 200. 近侧塞210可以设置有如图所示的凹入插口224,该凹入插口224用于可移除地接纳用于沿任一方向转动近侧塞210的工具,例如五凸角驱动器(five-lobed driver)(未示出)。 The proximal plug 210 may be provided with a recessed socket 224 as shown in FIG., The recessed socket 224 for removably receiving a proximal rotation in either direction of the plug tool 210, for example, five lobe drive (five- lobed driver) (not shown). 可选地,其他合适类型的凹入插口、 狭槽、突出部和/或键式特征可以与相配合的驱动器一起使用。 Alternatively, other suitable types of recessed sockets, slots, protrusions and / or the keyed mating feature can be used with the drive. 致动器轴214的近侧端(该近侧端从远侧塞212向近侧延伸到融合器主体208内)可以进入穿过近侧塞210中的中心钻孔225。 The proximal end of the actuation of the actuator shaft 214 (from distal to the proximal end of the plug body 212 extends fusion proximally into 208) may enter through the proximal bore 210 in the center of the plug 225. 致动器轴214的近侧端可以如图所示地成形成接纳在相配合的驱动器插口(例如,五凸角插口,未示出)内,该相配合的驱动器插口可以通过中心钻孔225可移除地延伸到融合器主体208的中心中。 A proximal end of the actuator shaft 214 may be shaped to receive as shown in FIG mating drive socket (e.g., five lobes socket, not shown), the mating drive socket 225 through the central bore removably extends to the center of the cage body 208. 利用这种布置,近侧塞210和远侧塞212可以从UEC 200的近侧端独立地接近并旋转,使得UEC 200的近侧端204和远侧端206可以独立地扩张或收缩。 With this arrangement, the proximal plug 210 and distal plug 212 may be independently accessible from the proximal end of the UEC 200 and rotates, such that the proximal end 204 of the UEC 200 and distal end 206 may be independently expanded or contracted.

[0076] 参考图14,示出了UEC 200的远侧端206的端部视图。 [0076] Referring to Figure 14, there is shown an end view of the distal end 206 of the UEC 200. 通过比较图13和图14,可以理解,UEC 200的近侧端204处的连接器部分222相对于UEC 200的远侧端206处的连接器部分222交错(即旋转45°)。 By comparing FIGS. 13 and 14, can be appreciated, the connector at the proximal end 204 of the UEC 200 relative to the connector portion 222 at the distal end 206 of the UEC 200 interleave portion 222 (i.e., rotation of 45 °).

[0077] 参考图15,示出了UEC 200的侧向剖视图。 [0077] Referring to FIG 15, shows a side cross-sectional view UEC 200. 在操作中,通过将诸如五凸角驱动器(未示出)的工具插入近侧塞210的凹入插口224中并顺时针转动工具,可以使UEC 200的近侧端204独立地扩张。 In operation, the tool by the driver, such as a five lobes (not shown) is inserted into a proximal socket 224 210 of the plug recess and the tool is rotated clockwise, the proximal UEC 200 allows the end 204 to expand independently. 顺时针转动近侧塞210导致塞210的带螺纹的倾斜表面232沿着沿梁部分218和连接器部分222的内侧定位的带螺纹的倾斜表面234向内(在图15中向右)平移,以使这些元件径向地向外弯曲和扩张,如之前所述的。 The proximal plug 210 is rotated clockwise resulting in the inclined surface 210 of the threaded plug 232 along the beam portion along the inclined surface 218 and an inner threaded connector portion 222 located inwardly of translation 234 (to the right in FIG. 15), so that these elements and bent radially outwardly expanded, as described previously. 通过逆时针转动近侧塞210可以使该过程颠倒过来,从而允许UEC 200的近侧端204恢复到其未扩张状态。 The proximal plug 210 is rotated counterclockwise so that the process can be reversed, thereby allowing the proximal end 204 of UEC 200 to return to its unexpanded state. 类似地,通过将诸如五凸角插口(未示出)的工具经由近侧塞210中的中心钻孔225插入直到工具与致动器214的近侧端(致动器214附接到远侧塞212)接合,可以使UEC 200的远侧端206独立地扩张。 Similarly, by the jacks such as five lobes (not shown) of the tool via the proximal bore 210 in the center of the plug 225 is inserted into the tool until the proximal end 214 of the actuator (actuator 214 is attached to the distal plug 212) engages the distal end of UEC 200 may be 206 independently expanded. 逆时针(从近侧端来看)转动远侧塞212导致塞212的带螺纹的倾斜表面232沿着沿梁部分218和连接器部分222的内侧定位的带螺纹的倾斜表面234向内(在图15中向左)平移,以使这些元件径向地向外弯曲和扩张,如之前所述的。 Counterclockwise rotation (view from the proximal end) distal plug 212 led to the inclined surface 212 of the plug 232 along threaded portion 218 along the beam and a connector portion 222 positioned inside a threaded surface 234 is inclined inwardly (in to the left in FIG. 15) translation, so that these elements and bent radially outwardly expanded, as described before. 通过顺时针转动远侧塞212可以使该过程颠倒过来,从而允许UEC 200的远侧端206恢复到其未扩张状态。 By clockwise rotation of distal plug 212 so that the process can be reversed so as to allow the distal end 206 of UEC 200 to return to its unexpanded state.

[0078] 上述用于转动近侧塞210和远侧塞212的调节工具(未示出)可以一次一个插入UEC 200中。 [0078] The plug 210 for rotating the proximal and distal plug 212 of the adjusting tool (not shown) may be inserted one at a time in the UEC 200. 可选地,两个工具可以嵌套在一起,其中用于转动远侧塞212的工具穿过用于转动近侧塞的工具中的中心钻孔,如稍后将关于其他实施方案所示出和描述的。 Alternatively, two tools may be nested together, wherein the distal plug 212 for rotating the tool through the center of rotation for the boring tool in a proximal plug, as will be shown later with respect to other embodiments and description. 利用这种布置,两个工具可以同时地或独立地转动。 With this arrangement, two tools may be independently or simultaneously rotated. 在一些实施方案中,近侧塞210和远侧塞212均设置有右旋螺纹,使得当两个工具沿着相同的方向同时转动时,UEC 200的一端扩张,而另一端收缩, 从而改变UEC 200的外表面角度而基本上不改变其总体直径(S卩,基本上不改变UEC 200的中点处(midpoint)的直径或高度)。 In some embodiments, the proximal plug 210 and distal plug 212 is provided with a right hand thread, so that when the two tools simultaneously rotated in the same direction, UEC end 200 is expansion, contraction and the other end, thereby changing the UEC the angle of the outer surface 200 without substantially changing its overall diameter (S Jie, does not change substantially at the midpoint 200 UEC (midpoint) diameter or height). 例如,通过沿着相同的方向转动两个工具,可以通过UEC 200改变两个椎骨体之间的脊柱前凸的角度,而基本上不改变该两个椎骨体之间的高度。 For example, by rotating the two tools in the same direction, you can change the lordosis angle between the two vertebral bodies by UEC 200, without substantially changing the height between the two vertebral bodies.

[0079] 在其他实施方案中,塞210或212中的一个可以设置有右旋螺纹,而另一个塞设置有左旋螺纹。 [0079] In other embodiments, the plug 210 or 212 may be provided with a right hand thread, and the other left-handed thread provided with a plug. 在这些实施方案中,当两个调节工具沿着相同的方向同时转动时,UEC 200的两端204和206—起扩张或收缩,而基本上不改变UEC 200的外表面角度。 In these embodiments, when adjusting the two tools simultaneously rotated in the same direction, both ends of the UEC from 206- 204,200 and expansion or contraction, without substantially altering the angle of the outer surface of the UEC 200. 例如,通过沿着相同的方向转动两个工具,可以通过UEC 200改变两个椎骨体之间的高度,而基本上不改变该两个椎骨体之间脊柱前凸的角度。 For example, by rotating the two tools in the same direction, you can change the height between the two vertebral bodies by UEC 200, but does not substantially change between the two vertebral bodies lordotic angle.

[0080] 在一些实施方案中,塞210和212可以各自设置有具有彼此不同的螺距的螺纹。 [0080] In some embodiments, plugs 210 and 212 may each be provided with a thread having a pitch different from each other. 当两个调节工具一起一致地转动时,这种布置允许相邻椎骨体之间的高度和角度以预定关系被同时地调节。 When the two adjustment means in unison with the rotation, this arrangement allows the height and angle between adjacent vertebral bodies in a predetermined relationship are simultaneously adjusted. 例如,近侧塞210可以设置有具有特定螺距的右旋螺纹,而远侧塞212可以设置有更精细的左旋螺纹,该左旋螺纹具有近侧塞螺纹的一半螺距。 For example, the proximal plug 210 may be provided with a right-hand thread having a certain pitch, the distal plug 212 may be provided with a finer left-handed threads, the pitch of the left-handed thread having a proximal half of the threads of the plug. 在该实施方案中,当两个调节工具一起沿着顺时针方向转动时,UEC 200的两端同时扩张,但是近侧端204以远侧端206的速率的两倍扩张。 In this embodiment, when the clockwise direction with two adjustment means, while the expansion UEC 200 ends, the proximal end 204 but at twice the rate of expansion of a distal end 206. 这允许外科医生增加相邻椎骨体之间的高度,并且同时使该椎骨体远离他或她成角度。 This allows the surgeon to increase the height between the adjacent vertebral bodies, and the vertebral body while away from his or her angled. 然后可以单独地转动一个或两个工具,以更精细地调节椎骨体之间的高度和角度。 You may then be rotated a single or two tools to more finely adjust the height and angle between the vertebral bodies.

[0081] 在一些实施方案中,在外科手术完成之前,上述调节工具可以从UEC 200移除。 [0081] In some embodiments, prior to surgery is completed, the tool may be removed from the adjusting UEC 200. 在一些实施方案中,在手术完成之后,上述调节工具可以保留在适当位置 In some embodiments, after the procedure is completed, the adjusting tool can remain in place

[0082] 在一些实施方案中,UEC 200为50mm长,具有IOmm的未扩张直径和14mm的扩张直径。 [0082] In some embodiments, UEC 200 is 50mm long with IOmm unexpanded diameter and an expanded diameter of 14mm. 在其他实施方案中,UEC可以配置为扩张至约11mm、12mm或13mm、或超过14mm。 In other embodiments, UEC can be configured to expand to about 11mm, 12mm or 13mm, or more than 14mm. 在还有的其他实施方案中,UEC可以配置为具有比这些更大或更小的尺寸,以符合特定的解剖体或手术。 In still other embodiments, the UEC may be configured with larger or smaller than these dimensions to fit a particular anatomy or surgery.

[0083] 参考图16-20,示出了根据本公开的方面的示例性UEC 300的第三实施方案。 [0083] Referring to FIG. 16-20, there is shown a third embodiment 300 according to an exemplary embodiment UEC aspect of the present disclosure. 图16 是表示UEC 300的细节的透视图。 FIG 16 is a perspective view of the detail of the UEC 300. UEC 300包括近侧端304和远侧端306,并且共享先前所述的UEC 100和200的许多相同的特征,该相同的特征用类似的参考数字标识。 UEC 300 includes a proximal end 304 and a distal end 306, and shares many features UEC 100 and 200 previously described, the same features identified by like reference numerals.

[0084] 参考图17,其为示出了UEC 300的单独的部件的分解透视图。 [0084] Referring to FIG 17, which is shown an exploded perspective view of a single member of the UEC 300. 在该第三实施方案中,UEC 300包括矩形融合器主体308、近侧塞310、远侧塞312、近侧塞调节工具313和远侧塞调节工具314。 In this third embodiment, UEC 300 includes a rectangular cage body 308, a proximal plug 310, the plug 312 distal, proximal plug 313 and distal plug adjusting tool adjustment tool 314. 与先前所述的UEC 200中的一样,塞310和312都是带有螺纹的且成锥形的,并且融合器主体308的每个端部设置有向内逐渐变小且带有螺纹的钻孔,该孔配置为接纳塞310或312中的一个。 And 200 as previously described in the UEC, plugs 310 and 312 are threaded and tapered, and each end of the cage body 308 is provided with tapers inwardly and threaded drill an aperture disposed in a 310 or 312 access Pvt. 调节工具313和314在结构和操作上类似于先前关于UEC 200所述的调节工具(但未示出)。 Regulating means 313 and 314 is similar in structure and operation to the tool previously described with respect adjusting UEC 200 (but not shown). 近侧塞310在其近侧端(未示出)上包括配合凹槽,该配合凹槽配置为可移除地接纳近侧塞调节工具313的花键式远侧端,该花键式远侧端用于旋转近侧塞310。 The proximal plug 310 at its proximal end (not shown) comprising a mating recesses, the mating recess configured to removably receive a plug adjusting tool 313 proximal of a distal splined end, the splined away for rotating the proximal end side of the plug 310. 远侧塞312在其近侧端(未示出)上包括较小的配合凹槽,该较小的配合凹槽配置为可移除地接纳远侧塞调节工具314的较小的花键式远侧端,该较小的花键式远侧端用于旋转远侧塞312。 The distal plug 312 at its proximal end (not shown) comprising a mating recess on the smaller, the smaller the fitting recess configured to removably receive a smaller splined distal plug 314 of the adjusting tool the distal end of the smaller splined for rotating the distal end of the distal plug 312. 近侧塞调节工具313和近侧塞312都设置有中心钻孔,该中心钻孔允许远侧塞调节工具314的远侧端穿过该中心钻孔、通过融合器主体308的中心、并部分地进入远侧塞312中。 The proximal plug and adjusting tool 313 proximal the plug 312 are provided with a central bore, the central bore allows the distal end of the distal plug adjusting tool through the central bore 314, through the center of the cage body 308 and partially into the distal plug 312. 在该示例性实施方案中,调节工具313和314的近侧端各自具有六角形头部,该六角形头部允许通过使用扳手、插口(未示出)、和/或通过手使调节工具313和314—起一致地转动或独立地转动(如先前关于UEC 200所述的)。 In this exemplary embodiment, the adjustment tool 313 and the proximal end 314 each having a hexagonal head, which allows the use of a hexagonal head wrench, a socket (not shown), and / or by hand so that the adjustment tool 313 from 314- and rotates in unison or independently rotated (as previously in the UEC 200).

[0085] 如图16和图17所示的,融合器主体308包括八个纵向延伸的梁部分318,每个梁部分318与相邻的梁部分218被纵向延伸的间隙320间隔开。 Shown in [0085] 16 and 17, the cage body 308 includes a beam portion 318 extending longitudinally eight, each beam section 318 and the gap 218 is adjacent beams longitudinally extending portion 320 spaced apart. 在其它实施方案(未示出)中,融合主体可以包括少于或多于八个梁部分和/或具有不同的或变化的横截面的梁部分。 In other embodiments (not shown), the fusion body may comprise fewer or more than eight beam portions and / or portions of the beam cross section has different or varying. 可以看出,在该实施方案中,间隙320中的四个通过融合器主体308的四个面的中央部形成,而另外四个间隙320沿着融合器主体308的角部边缘形成。 As can be seen, in this embodiment, the gap 320 is formed through a central portion of the four faces of the four fusion body 308, while the other four gaps 320 are formed along the corner edge portion 308 of the cage body. 融合器主体308还包括八个周向延伸的连接器部分322。 Cage body 308 further includes eight circumferentially extending connector portion 322. 连接器部分322将梁部分318的端部相互连接起来。 The connector portion 322 of the end portion of the beam portion 318 is connected to each other. 可以在间隙320的端部和连接器部分322之间设置如图所示的圆形孔321,以减轻当连接器部分322弯曲时在那些位置处的应力集中。 Circular hole 321 may be provided as shown in the gap 320 between the end portion and the connector portion 322, in order to reduce the stress concentration at those locations when the connecting portion 322 is bent. 连接器部分/弯曲部322中的四个位于融合器主体308的近侧端304处(横跨融合器主体308的角部边缘),而另外四个连接器部分/弯曲部322位于远侧端306处(横跨融合器主体308的表面的远侧端)。 Connector portion / curved portion 322 of the fusion of the four body 308 at a proximal end 304 (across the corner edges of the fused body 308), while the other four connector portion / curved portion 322 located at a distal end 306 (across the surface of the cage body 308 of distal end). 位于近侧端304处的连接器部分322与位于远侧端306处的连接器部分322交错,使得每对相邻的梁部分318仅在一端处通过连接器部分322连接。 Located at the proximal end 304 of the connector portion 322 located at the distal end 306 of the connector portion 322 are staggered such that each pair of adjacent beams only at a portion 318 connected by a connector portion 322 at one end. 与先前所述的实施方案一样,梁部分318和连接器部分322形成连续的蛇形或重复的S形图案。 As with the previously described embodiment, the beam portion 318 and the connector portion 322 to form a continuous serpentine or S-shaped repeating pattern. 梁部分318和或连接器部分322配置为弹性地弯曲,以允许融合器主体308在被塞310 和312径向地向外推动时周缘增加。 Or beam portion 318 and connector portion 322 is configured to elastically bend to allow the cage body 308 is increased when the peripheral edge 310 and the plug 312 push radially outward. 当塞310和312不径向地向外推动融合器主体308时,梁部分318和/或连接器部分322的弹性允许融合器主体308恢复到其初始减小的周缘。 When the plugs 310 and 312 are not driven radially outwardly when the cage body 308, the elastic portion 318 and / or the connector 322 of the beam portion 308 allows the cage body to recover its initial periphery decreases. 可以理解,当梁部分318和或连接器部分322向外弯曲时,间隙320在其与连接器部分322相对的开口端处变宽。 It will be appreciated, when the beam portion or the connection portion 318 and 322 is bent outward, the gap 320 is widened at its end opposite the connector opening portion 322. 梁部分318的面向外的表面可以各自设置有如图所示的一个或更多个尖或尖状部323,以允许融合器主体308抓牢椎骨体的终板。 An outer surface facing the beam portion 318 may each be provided with one or more sharp or pointed with a portion shown in FIG. 323, the cage body 308 to allow the gripping of the vertebral body endplates. 在该示例性实施方案中,沿着UEC 300 的顶部和底部设置带尖的或滚花的表面,而侧表面保持平滑。 In the exemplary embodiment, along the top and UEC bottom 300 provided with a pointed or knurled surface, and the side surface remains smooth.

[0086] 参考图18和图19,分别示出了UEC 300的侧视图和侧向剖视图。 [0086] with reference to FIGS. 18 and 19, show a side view and a side 300 UEC sectional view. 在操作中,通过将近侧塞调节工具313插入近侧塞310的相配合的凹入插口(如图19所示)中并将其顺时针转动,可以使UEC 300的近侧端304独立地扩张。 In operation, the adjustment tool through the proximal plug 313 is inserted into the proximal plug socket mating recess 310 (FIG. 19) and turn it clockwise, it is possible that the proximal end 304 of the UEC 300 independently expand . 顺时针转动近侧塞310导致塞310的带螺纹的倾斜表面332沿着沿梁部分318和连接器部分322的内侧定位的带螺纹的倾斜表面334向内(在图18和图19中向左)平移,以使这些元件径向地向外弯曲和扩张,如之前所述的。 The proximal plug 310 is rotated clockwise resulting in the inclined surface of the threaded plug 310 is threaded along the beam 332 along the inner side of the positioning portion 318 and connector portion 322 of the inclined surface 334 inwardly (to the left in FIG. 18 and FIG. 19 ) translation, so that these elements and bent radially outwardly expanded, as described before. 通过逆时针转动近侧塞310可以使该过程颠倒过来,从而允许UEC 300的近侧端304恢复到其未扩张状态。 The proximal plug 310 is rotated counterclockwise so that the process can be reversed, thereby allowing the proximal end 304 of UEC 300 to return to its unexpanded state. 类似地,通过将诸如五凸角插口(未示出)的工具经由近侧塞310中的中心钻孔325 插入直到工具与致动器314的近侧端(其附接到远侧塞312)接合,可以使UEC 300的远侧端306独立地扩张。 Similarly, by the (not shown) such as a five lobe tool via the proximal plug socket center bore 310 until the proximal end of the insertion tool 325 and the actuator 314 (which is attached to the distal plug 312) engagement, the distal end can UEC 300 306 independently expanded. 逆时针(从近侧端来看)转动远侧塞312导致塞312的带螺纹的倾斜表面332 沿着沿梁部分318和连接器部分322的内侧定位的带螺纹的倾斜表面334向内(在图18和图19中向右)平移,以使这些元件径向地向外弯曲和扩张,如之前所述的。 Counterclockwise rotation (view from the proximal end) distal plug 312 leads to a threaded inclined surface 312 of the plug 332 along the direction of beam portion 318 and the connector 322 is positioned inside portion of the inclined surface 334 threaded inwardly (in 18 and FIG. 19 right) translation, so that these elements and bent radially outwardly expanded, as described before. 通过顺时针转动远侧塞312可以使该过程颠倒过来,从而允许UEC 300的远侧端306恢复到其未扩张状态。 By clockwise rotation of distal plug 312 so that the process can be reversed so as to allow the distal end 306 of the UEC 300 to return to its unexpanded state.

[0087] 参见图20A-20C,其为示出了从完全缩回至完全扩张的UEC 300的进程的一系列侧视图。 [0087] Referring to FIGS. 20A-20C, which is a side view illustrating a series of processes from a fully retracted to a fully expanded the UEC 300. 在图20A中,融合器主体308示出为处于完全缩回位置。 In FIG 20A, the fusion body 308 shown in a fully retracted position. 在该图中,融合器主体308的每个端部的高度被标记为缩回的融合器高度的100%。 In the figure, the height of each end of the cage body 308 is retracted marked as 100% of the height of the cage. 在图20B中,融合器主体308的近侧端304已经完全扩张,而远侧端306保持完全缩回。 In FIG. 20B, the proximal end 304 of the cage body 308 has been fully expanded, while the distal end 306 remains fully retracted. 在该示例性实施方案中,每个端部能够扩张到完全缩回高度的140%的高度(以及因此宽度也是如此),如图所示。 In the exemplary embodiment, each end can be expanded to a fully retracted to 140% of a height (width and thus too), as shown in FIG. 在图20C中,远侧端306也扩张了40 %。 In FIG. 20C, the distal end 306 is also expanded by 40%.

[0088] 在一些实施方案中,UEC 300具有50mm的融合器长度、IOmm的未扩张的融合器高度和14mm的扩张的融合器高度。 [0088] In some embodiments, UEC 300 having a length of 50mm fusion device, the height of the fusion cage unexpanded IOmm height of 14mm and expansion. 在调节工具313和314保持就位的情况下且处于未扩张状态下的UEC 300的总体长度可以为75mm。 In the case where the regulating means 313 and 314 and held in place in the overall length of the UEC 300 unexpanded state may be 75mm. 在其他实施方案中,UEC可以配置为扩张至约11mm、12mm 或13mm、或超过14mm。 In other embodiments, UEC can be configured to expand to about 11mm, 12mm or 13mm, or more than 14mm. 在还有的其他实施方案中,UEC可以配置为具有比这些更大或更小的尺寸,以符合特定的解剖体或手术。 In still other embodiments, the UEC may be configured with larger or smaller than these dimensions to fit a particular anatomy or surgery. 在一些实施方案中,UEC可以在其顶表面和底表面之间形成至少20度的角度。 In some embodiments, UEC may form an angle of at least 20 degrees between its top and bottom surfaces.

[0089] 参考图21,示出了根据本公开的方面的示例性UEC 400的第四实施方案。 [0089] Referring to FIG 21, illustrates a fourth embodiment 400 according to an exemplary embodiment UEC aspect of the present disclosure. 图21是表示UEC 400的细节的透视图。 FIG 21 is a perspective view of the detail of the UEC 400. UEC 400包括近侧端404、远侧端406、融合器主体408、近侧塞410、远侧塞412、近侧塞调节工具413和远侧塞调节工具414。 UEC 400 includes a proximal end 404, a distal end 406, cage body 408, a proximal plug 410, the plug 412 distal, proximal plug 413 and distal plug adjusting tool adjustment tool 414. 除了融合器主体408具有圆形横截面而不是方形横截面外,UEC 400在结构和操作上基本上与先前所述的UEC 300相同。 In addition to the cage body 408 having an outer circular cross-section instead of square cross-section, 400 is substantially identical in construction and 300 UEC operation previously described UEC. 在其他实施方案(未示出)中,UEC可以具有横向于中心纵向轴线的矩形、梯形、卵形、椭圆形或其它形状的横截面。 In another embodiment (not shown), the UEC may have a cross-section transverse to the central longitudinal axis of the rectangular, trapezoidal, oval, elliptical, or other shape.

[0090] 参考图22-25,示出了根据本公开的方面的示例性UEC 500的第五实施方案。 [0090] Referring to FIG. 22-25, shows a fifth embodiment 500 in accordance with an exemplary embodiment UEC aspect of the present disclosure. 图16 是表示UEC 500的细节的透视图。 FIG 16 is a perspective view of the detail of the UEC 500. UEC 500包括近侧端504和远侧端506,并且共享先前所述的UEC 100-400的许多相同的特征,该相同的特征用类似的参考数字标识。 UEC 500 includes a proximal end 504 and a distal end 506, and share many of the same features of the previously described UEC 100-400, the same features identified by like reference numerals.

[0091] UEC 500包括三个部件:大体上圆柱形的、单件式的融合器主体508;近侧致动器螺杆510;和远侧致动器螺杆512。 [0091] UEC 500 comprises three components: a generally cylindrical, one-piece cage body 508; 510 screw proximal actuator; and a distal actuator screw 512. 致动器螺杆510和512的头部可以被称作塞构件。 The actuator screw 510 and the head 512 may be referred to as a plug member. 融合器主体508包括两个纵向偏心的狭槽550,该两个纵向偏心的狭槽550各自延伸约融合器主体508的长度的四分之三,并且从融合器主体508的相对的端部和相对的侧面发出。 Fusion eccentric body 508 includes two longitudinal slots 550, the two eccentric longitudinal slots 550 each extend about three quarters of the length of the cage body 508, and from the opposite ends of the body 508 and cage issued opposite side. 融合器主体508 还设置有两个横向狭槽552,该两个横向狭槽5 5 2各自邻近纵向狭槽5 50中的一个的闭合端部定位。 Fusion body 508 is also provided with two lateral slots 552, each of the two transverse slot adjacent to a longitudinal slot 550 in closed end 552 is positioned. 每个横向狭槽552从融合器主体508的外周缘延伸并接近纵向狭槽550的基部。 Each transverse slot 552 extending from the outer periphery of the cage body 508 and near the base of the longitudinal slot 550. 具有横向狭槽552的两对纵向狭槽550中的每对界定悬臂554,该悬臂554通过靠近两个狭槽550 和552的闭合端部的活动铰链556与融合器主体508的剩余部分连接。 Two pairs of longitudinal slots 550 has a transverse slot 552 define a cantilever 554 of each pair of the cantilever 554 by close the remaining portion of the movable two slots 550 and a closed end portion 552 of the hinge 556 and the cage body 508 is connected. 每个活动铰链556允许其相关联的臂554紧靠着椎骨体向外弯曲。 Each living hinge 556 allows its associated arm 554 is bent outwardly against the vertebral bodies.

[0092] 纵向狭槽550的开口端向外逐渐变小,以接纳致动器螺杆510或512的扩大的锥形头部,如图24中最佳示出的。 [0092] The open end of the longitudinal slot 550 tapers outwardly to receive the actuator screw enlarged conical head 510 or 512, as best shown in 24. 致动器螺杆510和512的相对的端部延伸通过纵向狭槽550并且旋入融合器主体508的相对的端部中。 The actuator screw 510 and an opposite end portion 512 extends through the longitudinal slots 550 and screwed into the opposite end of the cage body 508. 利用这种布置,每个致动器螺杆510和512可以彼此独立地转动,使得螺杆相对于骨融合器508轴向地移动。 With this arrangement, each screw actuator 510 and actuator 512 may be rotated independently of each other, so that the screw relative to the bone fusion 508 to move axially. 这种轴向移动使得螺杆的头部将相关联的臂554的锥形末端向外推动,或者当螺杆沿着反方向转动时允许其向内弯曲回去。 This axial movement of the screw head portion such that the conical end of the arm 554 associated with the push outwardly or inwardly curved back allows it when the screw is rotated in the opposite direction. 如果两个致动器螺杆510和512沿着相同的方向转动相同的量,则UEC 500均匀地扩张并且增加相邻椎骨体之间的高度。 If the two actuators 510 and screw 512 is rotated the same amount in the same direction, the UEC 500 expands and uniformly increasing the height between adjacent vertebral bodies. 如果两个致动器螺杆510或512中的一个比另一个转动更多,则夕卜科医生能够改变椎骨体之间的角度。 If a two actuator screw actuator 510 or 512 is rotated more than the other, then the physician can change the angle Xi Boke between the vertebral bodies.

[0093] 如图23中最佳示出的,可以在与螺杆头部相对的端部处在每个致动器螺杆510和512的端部中设置狭槽558或其他合适的特征。 [0093] best shown in FIG. 23, and 558, or may be in other suitable characteristic, each actuator screw 510 and the end portion 512 of the slot is provided at an end portion opposite to the screw head. 还可以穿过融合器主体508的每个端部设置孔560,以允许接近两个狭槽558中的每个。 Can also pass through each end of the cage body 508 is provided hole 560, to allow access to two slots 558 each. 这种布置允许致动器螺杆510和512从融合器主体508的任一端504和/或506转动。 This arrangement allows the actuator screws 510 and 512 rotate from either end of the body 508 of the cage 504 and / or 506.

[0094] 参考图26-28,示出了串联使用两个UEC 56的示例性实施方式。 [0094] with reference to FIGS. 26-28, there is shown an exemplary embodiment used in series two UEC 56 of the embodiment. 每个UEC 56可以如先前关于图1-3所述地插入。 Each UEC 56 can be inserted as previously 1-3 in FIG. 在这种实施方式中,UEC 56布置成彼此不平行。 In this embodiment, UEC 56 arranged not parallel to each other. 如图28中最佳示出的,这种布置允许外科医生调节椎骨围绕两个不同轴线的角度,并且还使椎骨围绕另一个轴线相对于彼此平移。 As best shown in FIG. 28, which allows the surgeon to adjust the angular arrangement about the two different axes of the vertebrae, and also to enable translation of the vertebrae relative to one another about the other axis.

[0095] 图29是示出了前柱植入物56置于椎骨体52上的斜前视图。 [0095] FIG. 29 is a diagram illustrating a front pillar of the implant 56 is placed on an oblique front view of the vertebral body 52. 在该实施方式中,植入物56在横向中线(lateral midline)的前方横向地放置在椎骨体52上。 In this embodiment, the implant 56 in front of the transverse center line (lateral midline) disposed transversely to the vertebral body 52. 在调节植入物56之后,其塞与椎骨体52的终板的外周缘齐平或凹入椎骨体52的终板的外周缘内,以免冲击相邻的组织。 After adjusting the implant 56, the outer periphery of which the plug body 52 and the vertebral end plate flush with or recessed in the outer periphery of the vertebral body endplates 52, in order to avoid the impact of adjacent tissue.

[0096] 参考图30,人类脊柱76示出为呈现脊柱侧凸。 [0096] Referring to FIG 30, a human spinal column 76 as shown exhibits scoliosis. 根据本公开的方面,双重UEC可以放置在脊柱的不同水平处以治疗病症。 According to aspects of the disclosure, dual UEC can be placed at different levels of the spine to treat disorders impose. 例如,可以在图30中示出的由参考数字78、80、82和84 所示的水平处植入单个UEC或成对的UEC。 For example, at the level indicated by reference numerals 78,80, 82 and 84 may be illustrated in FIG. 30 or implant a single pair of UEC UEC. 通过以上关于图28所述的调节,可以在这四个水平处在三维空间上调节脊柱的弯曲度至矫正对准,如图31所示。 By adjusting the above with respect to FIG. 28, the curvature of the spine can be adjusted in three-dimensional space to correct alignment of the four levels, as shown in Fig.

[0097] 图32A-32C分别是示出了具有未对准/不均匀间隔的相邻的椎骨体50和52的前视图、侧视图和斜视图。 [0097] FIGS. 32A-32C are a front view illustrating a misaligned / unevenly spaced adjacent vertebral bodies 50 and 52, a side view and a perspective view in FIG.

[0098] 图33A-33C分别是示出了根据本公开的方面的已对错位/不均匀间隔进行矫正的图32A-32C的椎骨体50和52的前视图、侧视图和斜视图。 [0098] FIGS. 33A-33C are diagrams illustrating a front view of the vertebral bodies 50 and 52 have according to the misalignment / unevenly spaced corrected FIG aspect of the present disclosure 32A-32C, a side view and a perspective view in FIG.

[0099] 植入物可以由例如诸如钛、64钛或其合金的材料、316或321不锈钢、可生物分解且生物活性的材料(例如干细胞)、和聚合物(例如由两个醚基和一个酮基的重复单体组成的半结晶型高纯度聚合物,例如聚醚醚酮(PEEK) TM或Tef IonTM)制成。 [0099] The implant can be, for example, may be biodegradable, such as titanium, or a titanium alloy material 64, 316 or 321 stainless steel and the material of biological activity (e.g., stem cells), and polymers (for example, a two ether groups and one semi-crystalline polymer comprising recurring monomers of high purity keto group consisting of, for example, made of polyether ether ketone (PEEK) TM or Tef IonTM).

[0100] 在植入后为了防止近侧塞和远侧塞或致动器的移动,在一些实施方式中,可以在一个或更多个移动部件上施加生物相容性粘合剂或螺纹锁紧脂(thread locking compound)。 [0100] In order to prevent the plug and the proximal or distal movement of the actuator piston, in some embodiments, the biocompatible adhesive may be applied or thread lock on one or more moving parts after implantation tight lipid (thread locking compound). 在一些实施方案(未示出)中,销可以径向地或轴向地插在塞/致动器和融合器主体之间,以在手术后将零件锁定在合适的位置。 In some embodiments (not shown), the pin can be inserted radially or axially between the actuator and the plug body fusion / activated, after surgery to the part locked in position. 在一些实施方案中,可以为此目的提供棘轮、装有弹簧的棘爪或其它锁定机构。 In some embodiments, the ratchet may be provided for this purpose, a spring loaded detent or other locking mechanism.

[0101] 通常,如上述实施方案所公开的,融合器主体在每个狭槽的每隔一端处被切开,类似于正弦波,这允许当融合器的中心被圆锥形或钻形(mandrill)的单元占据时扩张。 [0101] Generally, as disclosed in the above-described embodiments, the cage body is cut every other one end of each slot, similar to a sine wave, which allows the fusion device when the center is conical or subulate (Mandrill ) when the expansion unit is occupied. 融合器主体的一系列交替的狭槽允许进行扩张,同时保持UEC的外部为一个单一件。 Cage body a series of alternating slots allow for expansion, while maintaining an external UEC is a single piece. 狭槽加上表面上的齿允许牢固地抓住骨骼表面,并允许大量的骨长入机会。 Slots plus teeth on the surface allows firmly grasp the bone surface, and allow plenty of opportunity for bone ingrowth. 此外,通过允许外科医生使UEC的一端比另一端更厚,圆锥形(钻形)引入物的作用从均匀地到选择性地改变导管扩张。 Further, by allowing the surgeon UEC end thicker than the other end, a conical (subulate) was introduced into the action change uniformly to the dilatation selectively. UEC的扩张机制可适用于固定融合的和可移动“运动保留”植入物,其中根据外科医生的选择来确定扩张植入物的外观(圆形的、扁平的、定制的等等)。 UEC expansion mechanism applicable to the fusion of the fixed and movable "Movement reservation" implant, which is determined according to the selection of the surgeon expandable implant appearance (round, flat, customized, etc.). 因此,在一些实施方式中,相对运动可以在邻近植入的UEC的椎骨体之间保留。 Thus, in some embodiments, the relative movement may remain implanted between adjacent vertebral bodies of UEC. 在其他实施方式中,可能期望将相邻的椎骨体围绕所植入的UEC来融合。 In other embodiments, it may be desirable to adjacent vertebral bodies to fuse around the implanted UEC.

[0102] 为了提供相邻的椎骨之间的运动保留,可以在UEC和一个或两个椎骨终板之间使用结实的可压缩材料,和/或UEC的一个或更多个部件可以使用这种材料。 [0102] In order to provide motion between the vertebrae adjacent retention, strong compressible material may be used between one or two and UEC vertebral endplates, and / or one or more components of UEC can use this material. 这些材料可以复制自然的椎间盘的环(annulus)和核(nucleus)的载荷分布和冲击吸收功能。 These materials may copy natural disc ring (Annulus) and the load distribution and impact nucleus (Nucleus) absorbing function. 例如,在一些实施方案中,UEC可以设置有由弹性聚合物制成的锥形塞,以允许UEC压缩和扩张,以适应相邻椎骨的相对运动。 For example, in some embodiments, UEC may be provided with a tapered plug made of an elastic polymer to permit UEC compressed and expanded to accommodate relative movement of the adjacent vertebrae. 适用于某些UEC实施方案的生物相容性材料的示例包括由宾夕法尼亚州埃克斯顿市的DSM Biomedical提供的Bionate®、热塑性聚碳酸酯-聚氨酯(PCU)和由马萨诸塞州威明顿市的Ad vanSour ce B i oma t er ia I s 提供的C hr〇n〇FI ex ®、ITU。 UEC suitable for certain exemplary embodiments of the biocompatible material comprises Bionate® supplied by the city of Exton DSM Biomedical, thermoplastic polycarbonate - urethane (PCU) and a Wilmington, Massachusetts Ad vanSour ce B i oma C t er ia I s provided hr〇n〇FI ex ®, ITU.

[0103] UEC提供优于现有技术的优点,包括矫正冠状面畸形;为椎间体脊柱前凸和早期椎间体空间稳定引入大于现有隔离件设备的刚度。 [0103] UEC provide advantages over the prior art, including correction of coronal plane deformity; as interbody lordosis and early interbody space stably introduced stiffer than the conventional separator device. 这种早期稳定可改善手术后的疼痛,排除对后部植入物(包括椎弓根螺钉)的需求,并提高关节融合术的成功几率。 Such stability can be improved early post-operative pain, exclusion of the rear portion of the implant (including a pedicle screw) needs and to improve the chances of successful arthrodesis. 重要地,UEC提供对适用于神经元的空间的改善,同时改善脊柱前凸。 Importantly, UEC provide improved spatial apply to neurons, while improving lordosis. 传统的植入物仅限于隔离件效果,因为如果且当骨移植物在植入物中并围绕植入物融合时,椎间盘位置的被动填充物等待最终融合。 Traditional implant spacer effect only, because if and when the implant in the bone graft and fusion about the implant, filling the disc passive position awaiting final fusion. 通过扩张和变形至所计划的形状(其生理学上矫正脊柱角度),UEC立即将脊柱固定到其正确的、无痛的功能性位置。 By expansion and deformation to the shape of the intended (which physiologically correct the spine angle), the UEC spinal fixation immediately to its right, painless functional position. 当输注的骨诱导性/骨引导性骨移植材料愈合时,患者变好,并且植入物变得惰性且静止,嵌入骨骼中,并且不再需要。 When infusion of the osteoinductive / osteoconductive bone graft material to heal, the patient becomes good, and the implant becomes inert and still embedded in the bone, and is no longer required.

[0104] 在一些实施方案中,UEC的外表面可以是3D打印的,以不仅适配于椎骨间的空间本身,还可以配合每个插入位置处的表面形貌。 [0104] In some embodiments, the outer surface of the 3D UEC may be printed to only between themselves adapted to the intervertebral space, but also with the surface topography at each insertion location. 换句话说,可以使用由计算机计算的3D打印终板,以适配和扩张个体患者的椎间盘空间,得到用于融合的最佳“适配度”,和改善的轴向骨骼对准。 In other words, calculations can be used by the computer to print 3D endplate, and expansion of the disc space to fit the individual patient, the best 'goodness of fit' for fusion, and improved bone axially aligned.

[0105] 通过创建适配的“地图”,例如作为精确一致的上下表面,以适配到特定患者的椎间盘空间中,并且将这些UEC终板放置在新型UEC扩张机构的两侧,患者的椎间盘空间以及整体脊柱对准将朝向最佳融合(或运动保留)和对准被理想地治疗。 [0105] By creating an adapted "map", for example, as accurate and consistent vertical surfaces, to fit into the disc space for a specific patient, and these UEC endplates disposed on both sides of the expansion mechanism UEC new, patient's disc and the overall alignment of the spinal space toward the optimal fusion (or retention motion) and the alignment treatment is over.

[0106] “手术方法”说明可能建议外科医生和/或机器人单元依照编程开展扩张,以将UEC 插入病状的特定椎间盘水平,以达到最佳效果。 [0106] "surgical" describes the surgeon may be recommended and / or programmed to carry out the robot unit in accordance with the expansion at a specific disc level of the UEC inserted condition, in order to achieve the best results. 例如,术前患者的扫描/底片可以预测外科医生对UEC的理想使用,例如“顺时针转动旋钮A—定的旋转次数”,以最大化可视的、可触知的和X成像的“适配度”。 For example, preoperative scan / backsheet over the surgeon can predict the use of the UEC, such as "clockwise rotation of the knob A- predetermined number of times", to maximize visual, tactile imaging and X "fitness with a degree. " 利用这种方法,激活后,UEC植入物使用专用手术方法和所提供的UEC插入工具以预定的最佳角度(沿着3个轴线)进入而适配到一定位置。 With this method, after activation, UEC implants and surgical methods using dedicated UEC insertion tool provided at a predetermined optimum angle (along three axes) and is adapted to enter a predetermined position.

[0107] 在一些实施方案中,UEC可以涂覆有羟基磷灰石。 [0107] In some embodiments, UEC may be coated with hydroxyapatite. 在一些实施方案中,齿状的或400 Mi珠状表面可以用于促进骨长入。 In some embodiments, the teeth 400 Mi or bead surface may be used to promote bone ingrowth. 可以在终板内设置可充气腔室,该可充气腔室可以在植入之后扩张。 Inflatable chamber may be provided in the end plate, the inflatable chamber may be expanded after implantation. 该方法解决了3D—致性以贴近椎间盘病变。 The method solves the 3D- consistency to close disc disease. 这还可以允许椎骨间的关节融合术或关节成形术治疗,并且整体改善的脊柱对准,将内部专有扩张与变化的外部终板形状及其内容物相结合。 This may also allow intervertebral joint arthroplasty or fusion treatment, and improved overall alignment of the spine, the combined expansion and internal proprietary changing external shape of the end plate and its contents. 可以使用聚合物的UEC可充气终板,例如微小的囊泡、“气泡包装膜(bubbI ewrap) ”、和多个或单个囊状物结构体。 UEC polymers may be used inflatable endplate, e.g. tiny vesicles, "bubble wrapping film (bubbI ewrap)", and a single or a plurality of bladders structure. 如果椎间盘空间的一部分塌陷,则该区域可能会由于UEC终板在材料和/或充气上的变化而适当升高或扩张。 If a portion of the collapsed disc space, the region may be due to the end plate and UEC changes inflatable material and / or appropriately increased or expanded. 可充气腔室可以包含可压缩气体(例如空气)、颗粒(如,药物)、和/或通过液体输送的干细胞。 Inflatable chamber may comprise a compressible gas (e.g. air), particles (e.g., drugs), and / or by liquid delivery stem cells. 在UEC是可压缩的或强制吸收的情况下,材料和/或腔室可以用作缓冲物或以“选择性地引导并保护软骨细胞”朝向通过最佳药物使用或再生来改善现有的病理生理学。 In the case of the forced absorption or UEC compressible, material and / or chamber may be used to cushion or "selectively guide and protect the chondrocytes" by using the optimal orientation to improve existing drugs or pathological regeneration physiology.

[0108] UEC的插入位置的“制备”将根据外科医生而改变。 [0108] UEC insertion position "prepared" will vary depending on the surgeon. 在一些实施方式中,关节镜毛刺可以是可取的,以用于在数字关节镜镜头的控制下伴随着所有异常的椎间盘内容物移除0.5mm的皮质骨。 In some embodiments, the burr arthroscopy may be desirable, for all exceptions associated with the contents of the disc is removed 0.5mm cortical bone under arthroscopic control of the digital lens. 在其他实施方式中,外科医生可以仅仔细地刮椎骨间的空间,以在制备期间“将其清理干净”以用于UEC植入物的插入。 In other embodiments, the surgeon may carefully scraped only the space between the vertebrae during preparation in order to "clean up its" In UEC implant for insertion.

[0109] UEC可以直接插入到插入位置中,或者可以通过专用的或市面上有售的插入管被插入。 [0109] UEC can be directly inserted into the insertion position, or may be commercially available or a dedicated insertion tube is inserted. 插入管通常将具有钝的远侧末端,使得其可以通过切口被插入,而不引起组织损伤。 Insertion tube having a generally blunt distal tip, such that it can be inserted through the incision, without causing tissue damage. 该管可以与或不与另外的组织牵开器一起使用。 The tube may not be used with the retractor or with additional tissue. UEC可以预先加载到插入管中,或者在管已经被引入到插入位置中之后放入管中。 UEC into the tube after the insertion can be preloaded into the tube, or the tube has been introduced into the insertion position. 可以使用推杆或其他设备以将UEC从插入管部署到插入位置中。 Ram or other device may be used to UEC deployed from the insertion tube into the insertion position. 在一些手术中,可以借助于关节镜来放置UEC。 In some procedures, it can be placed by means of arthroscopic UEC.

[oho]注意到,无论终板的制备如何,在畸形、老化、病理性脊柱中将存在要矫正的病状。 [OHO] noted that, no matter how prepared endplate, deformity, aging, in the presence of a pathological condition to be corrected spine. 根据本公开的各个方面,本文提供的UEC当属于外部植入物组成时可以以多种方式来实现这一点。 According to various aspects of the present disclosure, provided herein are external UEC when the implant can be achieved in various ways that when components. 例如,UEC可以作为外部螺纹导管来扩张,或者在手术后端对端一致地扩张以在每个端部得到相同的直径(例如40%的总体扩张),或者在任一端精确地扩张,从而产生总体上圆锥形而扩张的UEC。 For example, as the UEC dilatation catheter outer thread, end to end or expand in unison after surgery to obtain the same diameter (e.g., 40% of the overall expansion) at each end, or at either end of the expansion precisely, producing either an overall and the conical expansion of the UEC. 此外,UEC可以如上图所示地是上下平坦的,因此更可能配合稍微平坦的椎骨体终板。 Further, as the UEC may be flat as shown in FIG down, therefore more likely to be slightly flat mating vertebral endplate. 然而,根据本公开的另外的方面,应特别注意,外围终板骨骼边缘即作为在椎骨体终板处的较厚的较突出皮质骨,具有下陷的或凹形的较薄的内部(因此经受可能的沉陷)。 However, according to a further aspect of the present disclosure, special attention should be, i.e., the peripheral edges of end plate bone thin as inside the vertebral body at the endplate is thicker than the projecting cortical bone, having a depressed or concave (and therefore subjected to possible subsidence). 本文考虑的UEC MOS (手术方法)考虑到术前发现(例如MRI、3D CT扫描、X射线),以整合对于骨密度、特定的椎间盘空间和纵向脊柱解剖体、形貌和对准的信息。 Contemplated herein UEC MOS (surgical) found consideration (e.g. MRI, 3D CT scans, X-rays) to the preoperative to integrate information on bone mineral density, and a particular longitudinal spinal disc space anatomy, morphology and alignment.

[0111] 本文公开的各种扩张融合器及其变型不限于用于脊柱中,而是可以在整个人或动物体内的其它骨节段之间使用。 [0111] Various stents are disclosed herein fusion and its variants are not limited to the spine, but may be used between the entire human or other animal bone segments. 例如,UEC可在跖关节的关节融合术期间使用。 For example, UEC can be used during the metatarsal joint arthrodesis. 在相对骨节段的融合发生之前,UEC可以帮助将脚趾的取向设置到所需的角度。 Opposing bone segments before fusion occurs, UEC can help to set the alignment of the toe angle required. 类似地,UEC可以用于膝关节、肘关节或其他身体关节中,或用于已经由于创伤折断的两个或更多个骨节段之间。 Similarly, UEC can be used for knee, elbow, or other joints in the body, or for trauma has been broken between two or more bone segments due.

[0112] 根据本公开的各个方面: [0112] According to various aspects of the present disclosure:

[0113] I) UEC局部地通过水平(椎间盘)和纵向垂直轴向(脊柱侧凸/脊柱后凸)脊柱畸形改善来矫正脊柱外科病理。 [0113] I) UEC locally by a horizontal (disc) and perpendicular to the longitudinal axis (scoliosis / kyphosis) to improve spinal deformity correction of spinal surgical pathology.

[0114] 2) UEC适用于颈椎到腰椎,用于 [0114] 2) UEC applied to the cervical spine, for

[0115] A)关节融合术(融合)或 [0115] A) arthrodesis (fusion) or

[0116] B)关节成形术(运动保留) [0116] B) Arthroplasty (motion Reserved)

[0117] C)药物/细胞治疗物的递送 [0117] C) deliver the drug / cell therapy was

[0118] 3) UEC可以在整个植入物长度上均匀地扩张,和/或仅在近侧端潮向手术切口)或向远侧地扩张,从而使得临床调节有利于脊柱患病的或受伤的患者的局部的或整体的脊椎病。 [0118] 3) UEC can be uniformly expanded over the entire length of the implant, and / or to surgical incisions) or expand distally so that the proximal end of clinical adjusted only facilitate the influx of diseased or injured spine the partial or whole spine disease patients.

[0119] 4) UEC可以作为安全有效的植入物通过门诊MIS (微创-门诊手术(Minimally Invasive-outpatient Surgery)) “无伤害地”通过外科手术插入,应用了以下应用优点 [0119] 4) UEC can be used as safe and effective implant outpatient MIS - inserted by surgery (outpatient minimally invasive surgery (Minimally Invasive-outpatient Surgery)) "harmlessly", apply the following advantages application

[0120] A)高度差的材料厚度,或 [0120] A) the material thickness of the height difference, or

[0121] B)手术控制的扩张调节(植入之前/期间或之后),或通过预制的入口或注射-编程植入物“映射”的矫正使用 [0121] B) regulating expansion control operation (prior to implantation / during or after), or by a preformed inlet or injection - Programming implant "mapped" using the correction

[0122] C)使用任意可变的压缩、固定性或可生物降解的激活物直接计算出的聚合物。 [0122] C) using any variable compression, fixed or activator biodegradable polymer directly calculated.

[0123] D)植入物的充气,如通过UEC表面腔室或囊状物。 Inflatable [0123] D) of the implant, such as by UEC surface of the chamber or bladder.

[0124] E)添加终板生物制剂、泡沫或其他适应物,以获得最佳效果。 [0124] E) Add biologies endplate, foam or other material adapted to get the best results.

[0125] F) UEC扩张可以适于扩张可变的外表面参数,包括平的、圆的或与关于接近的终板依接面定制的外部最大程度一致的表面。 [0125] F) UEC expansion can be adapted to the outer surface of the expansion of the variable parameters, including flat, rounded or uniform surface with respect to the proximity of the surface by custom external endplate maximum extent.

[0126] 5)通过UEC材料本身(包括物质一细胞或药物)或通过从UEC容器或递送囊泡/仓/ 腔室/门的挤出物递送,将不仅能够立即进行手术矫正,还可以长期增强骨的生长以及局部/ 一般治疗和/或再生临床益处。 [0126] 5) UEC by material itself (a substance comprises cells or drugs) or the surgical correction can be performed not only by the immediate delivery of the vesicles from the container or UEC / bin / chamber / delivery door extrudate can also long-term enhance bone growth, and local / general treatment and / or reproducing clinical benefit.

[0127] 虽然已经结合示例性实施方案描述了本公开,但是应当理解,本公开不限于如上所述的公开的实施方案和替代方案,而是相反地旨在覆盖包括在权利要求范围内的各种修改和等同的布置。 [0127] While there has been described in conjunction with exemplary embodiments of the present disclosure, it is to be understood that the present disclosure is not limited to the disclosed embodiments and alternatives described above, but on the contrary is intended to cover various within the scope of the claims modifications and equivalent arrangements.

Claims (20)

  1. 1. 一种可扩张医疗植入物,包括: 可植入融合器主体,其具有近侧端和远侧端,所述近侧端和所述远侧端各自设置有锥形部分,所述融合器主体还具有在所述融合器主体的所述近侧端和所述远侧端之间延伸的纵向轴线; 至少一个近侧弯曲部,其至少部分地定位成邻近所述融合器主体的所述近侧端,并配置为允许所述融合器主体的所述远侧端的周缘弹性地扩张; 至少一个远侧弯曲部,其至少部分地定位成邻近所述融合器主体的所述远侧端,并配置为允许所述融合器主体的所述近侧端的周缘弹性地扩张; 近侧塞构件,其具有配置为与所述融合器主体的所述近侧端的所述锥形部分相配合的锥形部分,所述近侧塞构件配置为相对于所述融合器主体从第一位置纵向地移动到第二位置,使得所述至少一个远侧弯曲部移动并且所述融合器主体的所述近侧端的周 1. An expandable medical implant, comprising: an implantable cage body having a proximal end and a distal end, said proximal end and said distal end are each provided with a tapered portion, said fusion body further having a longitudinal axis between the proximal end of the cage body and said distal end; at least one proximal bend portion, at least partially positioned adjacent to the body of the cage the proximal end and configured to allow the elastically expandable periphery of the distal end of the cage body; at least one curved distal portion, at least partially positioned adjacent to the body of the distal fusion end, and is configured to allow the peripheral edge of the proximal end of the resilient body is expanded fusion; proximal plug member having a configuration to cooperate with the body of the cage of the tapered portion of the proximal end the tapered portion of the plug member disposed proximal with respect to the cage body moves longitudinally from a first position to a second position, such that movement of said at least one curved distal portion and the main body of the cage said proximal end of the circumferential 缘弹性地扩张,并且所述近侧塞构件配置为相对于所述融合器主体从所述第二位置纵向地移动到所述第一位置,使得所述近侧端的周缘弹性地收缩;和远侧塞构件,其具有配置为与所述融合器主体的所述远侧端的所述锥形部分相配合的锥形部分,所述远侧塞构件配置为相对于所述融合器主体从第三位置纵向地移动到第四位置,使得所述至少一个近侧弯曲部移动并且所述融合器主体的所述远侧端的周缘弹性地扩张,并且所述远侧塞构件配置为相对于所述融合器主体从所述第四位置纵向地移动到所述第三位置,使得所述远侧端的周缘弹性地收缩。 Edge resiliently expandable, and said plug member disposed proximally with respect to the cage body moves longitudinally from the second position to the first position, so that the peripheral edge of the proximal end of the elastically shrinking; far and side plug member having a tapered portion configured to be fused with the body of the tapered portion of the distal end of the mating, the distal plug member disposed with respect to the body from the third fusion position to the fourth position to move longitudinally, such that the at least one proximal bend and the peripheral portion moves elastically expanding the distal end of the cage body, and the distal plug member disposed with respect to the fusion body moves longitudinally from the fourth position to the third position, such that the peripheral edge of the distal end of the elastically contracted.
  2. 2. 根据权利要求1所述的可扩张医疗植入物,其中所述融合器主体还包括在所述近侧端处的第一锥形钻孔和在所述远侧端处的第二锥形钻孔,所述第一锥形钻孔配置为可滑动地接纳所述近侧塞构件,所述第二锥形钻孔配置为可滑动地接纳所述远侧塞构件。 The expandable medical implant of claim 1, wherein said body further comprises a cage as claimed in claim a second conical taper in a first bore at the proximal end and the distal end of shaped bore, said first tapered bore configured to slidably receive the proximal plug member, the second tapered bore configured to slidably receive the distal plug member.
  3. 3. 根据权利要求2所述的可扩张医疗植入物,其中所述第一锥形钻孔与所述近侧塞构件可螺纹地接合,使得当所述近侧塞构件相对于所述融合器主体旋转时,所述近侧塞构件相对于所述融合器主体沿着纵向方向前进,并且其中所述第二锥形钻孔与所述远侧塞构件可螺纹地接合,使得当所述远侧塞构件相对于所述融合器主体旋转时,所述远侧塞构件相对于所述融合器主体沿着纵向方向前进。 The expandable medical implant of claim 2, wherein the first bore and the proximal tapered plug member threadably engaged such that when the proximal claim plug member with respect to the fusion when the rotary body, the plug member relative to the proximal cage body advances along the longitudinal direction, and wherein said second bore is engaged with the distal tapered plug member may be threaded, such that when the the distal plug member relative to the cage body is rotated, the distal plug member relative to the cage body advances along the longitudinal direction.
  4. 4. 根据权利要求1所述的可扩张医疗植入物,其中所述至少一个近侧弯曲部包括大体上圆形的且端部开放的开口和从所述开口纵向地延伸的一对大体上柔韧的梁部分。 The expandable medical implant of claim 1, wherein the curved portion comprises at least a proximal and a generally circular open end portion of the opening from the opening and a pair of generally longitudinally extending claims flexible beam portion.
  5. 5. 根据权利要求1所述的可扩张医疗植入物,其中所述至少一个近侧弯曲部包括一对纵向延伸的梁部分,所述一对纵向延伸的梁部分被纵向延伸的间隙间隔开,其中所述至少一个近侧弯曲部还包括将所述梁部分的近侧端相互连接起来的连接器部分。 The expandable medical implant of claim 1, wherein the at least one bent portion proximal portion includes a pair of longitudinally extending beams, a gap between the pair of beams longitudinally extending portion extending longitudinally spaced claim wherein said at least one curved portion further includes a proximal portion connected to the proximal end of the beam portion is connected to each other.
  6. 6. 根据权利要求1所述的可扩张医疗植入物,其中所述至少一个近侧弯曲部包括多个周向间隔开的近侧弯曲部,并且其中所述至少一个远侧弯曲部包括多个周向间隔开的远侧弯曲部。 6. The expandable medical implant of claim 1, wherein said at least one curved proximal portion includes a proximal portion bent a plurality of circumferentially spaced apart, and wherein said at least one curved portion comprises a distal plurality claim circumferentially spaced curved distal portion.
  7. 7. 根据权利要求6所述的可扩张医疗植入物,其中所述多个近侧弯曲部与所述多个远侧弯曲部旋转地交错。 According to claim expandable medical implant of claim 6, wherein the plurality of proximal portions of the plurality of curved portions curved distal rotationally staggered.
  8. 8. 根据权利要求7所述的可扩张医疗植入物,其中所述近侧弯曲部中的每个包括一对纵向延伸的梁部分,所述一对纵向延伸的梁部分被纵向延伸的间隙间隔开并且通过连接器部分桥接在一起,所述连接器部分仅将所述梁部分的近侧端相互连接起来,其中所述远侧弯曲部中的每一个包括一对纵向延伸的梁部分,所述一对纵向延伸的梁部分被纵向延伸的间隙间隔开并且通过连接器部分桥接在一起,所述连接器部分仅将所述梁部分的远侧端相互连接起来,并且其中所述近侧弯曲部中的每一个近侧弯曲部与所述近侧弯曲部中的邻近每一个近侧弯曲部的两个远侧弯曲部共享梁部分,从而沿着所述融合器主体形成连续的蛇形图案。 According to claim expandable medical implant of claim 7, wherein the proximal curved portion includes a pair of longitudinally extending beam portion, the portion of the gap between a pair of longitudinally extending beams extending longitudinally spaced apart and together by a bridging connector portion, said connector portion only to interconnect the proximal end of the beam portion, wherein each of said curved distal portion includes a pair of longitudinally extending beam part, a gap extending longitudinally of said pair of longitudinally extending beam portion and spaced by a bridging portion connecting together the connector part connected to each other only distal end of the beam portion, wherein the proximal and two distal portions bent beam portions each share a proximal portion of the proximal curved portion bent in the bent portion of each of the proximal curved portion adjacent to, thereby forming a continuous serpentine along the cage body pattern.
  9. 9. 根据权利要求1所述的可扩张医疗植入物,还包括第一调节构件,所述第一调节构件联接到至少所述近侧塞构件,使得当所述第一调节构件旋转时,使所述近侧塞构件纵向地移动。 9. The expandable medical implant according to claim 1, further comprising a first adjustment member, the first adjustment member is coupled to the at least a proximal plug member, such that when the first adjustment member is rotated, the proximal plug member is moved longitudinally.
  10. 10. 根据权利要求9所述的可扩张医疗植入物,还包括第二调节构件,所述第二调节构件联接到所述远侧塞构件,使得当所述第二调节构件旋转时,使所述远侧塞构件纵向地移动,从而允许所述融合器主体的所述近侧端和所述远侧端彼此独立地扩张和收缩。 Claim 10. The expandable medical implant of claim 9, further comprising a second adjustment member, the second regulating member is coupled to the distal plug member, such that when the second adjustment member is rotated, so that the distal plug member is moved longitudinally, so as to allow the cage body proximal end and a distal end of the expansion and contraction independently of each other.
  11. 11. 根据权利要求10所述的可扩张医疗植入物,其中所述第一调节构件和所述第二调节构件同轴地一个嵌套在另一个中并且可独立地旋转。 11. The method of claim 10 expandable medical implant, wherein said first member and said second regulating member adjusting a nested coaxially and independently rotatable in the other.
  12. 12. 根据权利要求11所述的可扩张医疗植入物,其中所述第一调节构件和所述第二调节构件各自具有轴向间隔开但彼此相邻的旋钮,使得所述旋钮能够交替地一起旋转或独立地旋转。 12. The expandable medical implant according to claim 11, wherein the first regulating member and the second regulating member having axially spaced apart but each adjacent a knob, so that the knob can be alternately rotate together or independently rotated.
  13. 13. 根据权利要求11所述的可扩张医疗植入物,其中所述第一调节构件和所述第二调节构件中的至少一个具有键式端部,所述键式端部配置为与其所关联的塞构件可滑动地配合且可旋转地联接,使得所述至少一个调节构件能够从所述可扩张医疗植入物移除。 Claim 13. The expandable medical implant of claim 11, wherein the first regulating member and the second regulating member at least one end portion having a button, the button configured to communicate with their end portions associated plug member fitted slidably and rotatably coupled, such that the at least one adjusting member can be from the expandable medical implant removal.
  14. 14. 根据权利要求1所述的可扩张医疗植入物,其中所述融合器主体具有横向于所述纵向轴线的方形横截面。 According to claim expandable medical implant of claim 1, wherein said cage body having a square cross section transverse to the longitudinal axis.
  15. 15. 根据权利要求1所述的可扩张医疗植入物,其中所述融合器主体具有横向于所述纵向轴线的圆形横截面。 Claim 15. The expandable medical implant of claim 1, wherein said cage body having a circular cross-section transverse to the longitudinal axis.
  16. 16. —种可扩张医疗植入物,包括: 可植入融合器主体,其具有近侧端和远侧端,所述近侧端和所述远侧端各自设置有带螺纹的且锥形的钻孔,所述融合器主体还具有在所述融合器主体的所述近侧端和所述远侧端之间延伸的纵向轴线; 多个周向间隔开的近侧弯曲部,其各自至少部分地定位成邻近所述融合器主体的所述近侧端并且配置为允许所述融合器主体的所述远侧端的周缘弹性地扩张,其中所述近侧弯曲部中的每一个包括一对纵向延伸的梁部分,所述一对纵向延伸的梁部分被纵向延伸的间隙间隔开并且通过连接器部分桥接在一起,所述连接器部分仅将所述梁部分的近侧端相互连接起来; 多个周向间隔开的远侧弯曲部,其各自至少部分地定位成邻近所述融合器主体的所述远侧端并且配置为允许所述融合器主体的所述近侧端的周缘弹性地扩张,其中 16. - Species expandable medical implant, comprising: an implantable cage body having a proximal end and a distal end, said proximal end and said distal end are each provided with a tapered and threaded drilling, the fusion body further has a longitudinal axis of the cage body between the proximal end and the distal end; a plurality of circumferentially spaced curved proximal portion, each of at least partially positioned adjacent to said body of said cage and configured to allow a proximal end of the resilient periphery of said distal end of said body to expand the cage, wherein each of said proximal portion comprises a curved extending longitudinally of the beam portion, a gap extending longitudinally of said pair of longitudinally extending beam portion and spaced by a bridging portion connecting together the connector portion only to interconnect the proximal end of the beam portion ; distal portion bent a plurality of circumferentially spaced apart, each at least partially positioned adjacent to the distal end of the cage body and configured to allow the proximal end of the cage body periphery elastically expansion, which 所述远侧弯曲部中的每一个包括一对纵向延伸的梁部分,所述一对纵向延伸的梁部分被纵向延伸的间隙间隔开并且通过连接器部分桥接在一起,所述连接器部分仅将所述梁部分的远侧端相互连接起来,并且其中所述近侧弯曲部中的每一个近侧弯曲部与所述近侧弯曲部中的邻近每一个近侧弯曲部的两个远侧弯曲部共享梁部分,从而沿着所述融合器主体形成连续的蛇形图案; 近侧塞构件,其具有配置为与所述融合器主体的所述近侧端的所述带螺纹的且锥形的钻孔相配合的带螺纹的且锥形的周缘,所述近侧塞构件配置为相对于所述融合器主体沿着所述纵向轴线从第一位置移动到第二位置,使得所述多个远侧弯曲部移动并且所述融合器主体的所述近侧端的周缘弹性地扩张,并且所述近侧塞构件配置为相对于所述融合器主体沿着所述纵向轴线从所述第二位置 Each section includes a pair of beams extending longitudinally in the distal curved portion of the pair of gap portions of longitudinally extending beams extending longitudinally spaced apart and connected by a bridging portion with the connector portion only the distal end of the beam portion is connected to each other, and wherein each of the proximal bend of the proximal portion of the proximal curved portion in the curved portion adjacent the curved proximal portion of each of two distal shared beam portions bent portion, to form a continuous serpentine pattern along the cage body; proximal plug member having a tapered configuration and said body of said cage and said proximal end of the threaded bore periphery cooperating tapered and threaded, said plug member is disposed proximally with respect to the cage body along the longitudinal axis from a first position to a second position, such that said plurality a curved distal portion and moved elastically expandable periphery of the proximal end of the cage body and said plug member disposed proximally with respect to the cage body along the longitudinal axis from the second position 移动到所述第一位置,使得所述近侧端的周缘弹性地收缩; 远侧塞构件,其具有配置为与所述融合器主体的所述远侧端的所述带螺纹的且锥形的钻孔相配合的带螺纹的且锥形的周缘,所述远侧塞构件配置为相对于所述融合器主体沿着所述纵向轴线从第三位置移动到第四位置,使得所述多个近侧弯曲部移动并且所述融合器主体的所述远侧端的周缘弹性地扩张,并且所述远侧塞构件配置为相对于所述融合器主体沿着所述纵向轴线从所述第四位置移动到所述第三位置,使得所述远侧端的周缘弹性地收缩; 第一调节构件,其可旋转地联接到所述近侧塞构件,使得当所述第一调节构件旋转时, 使所述近侧塞构件沿着所述纵向轴线移动;和第二调节构件,其可旋转地联接到所述远侧塞构件,使得当所述第二调节构件旋转时, 使所述远侧塞构件纵向地移动,从 Moved to the first position, so that the peripheral edge of the proximal end of the elastically contracted; distal plug member having the configuration of the distal end of the cage body is tapered and threaded drill bore periphery cooperating tapered and threaded, said plug member disposed distal to said cage main body moves from the third position to the fourth position along the longitudinal axis with respect to, such that said plurality of near side curved portion and the peripheral movement of elastically expanding the distal end of the cage body, and the distal plug member disposed with respect to the cage main body is moved from the fourth position along the longitudinal axis to the third position, such that the peripheral edge of the distal end of the elastically contracted; a first adjustment member, which is rotatably coupled to the proximal plug member, such that when the first adjustment member when rotated to the the proximal plug member movement along the longitudinal axis; and a second adjusting member, which is rotatably coupled to the distal plug member, such that when the second adjustment member when rotated to the longitudinal distal plug member moved from 允许所述融合器主体的所述近侧端和所述远侧端彼此独立地扩张和收缩, 其中所述第一调节构件和所述第二调节构件同轴地一个嵌套在另一个中并且可独立地旋转,并且其中所述第一调节构件和所述第二调节构件各自具有轴向间隔开但彼此相邻的旋钮, 使得所述旋钮能够交替地一起旋转或独立地旋转。 Allowing the fusion of the proximal body end and a distal end of the expansion and contraction independently from each other, wherein the first regulating member and the second regulating member coaxially nested one into the other and independently rotatable, and wherein the first regulating member and the second regulating member having axially spaced apart but each adjacent a knob, such that the knob can be rotated together or individually alternately.
  17. 17. 根据权利要求16所述的可扩张医疗植入物,其中所述第一调节构件和所述第二调节构件中的至少一个具有键式端部,所述键式端部配置为与其所关联的塞构件可滑动地配合且可旋转地联接,使得所述至少一个调节构件能够从所述可扩张医疗植入物中移除。 Claim 17. The expandable medical implant of claim 16, wherein the first regulating member and the second regulating member at least one end portion having a button, the button configured to communicate with their end portions associated plug member fitted slidably and rotatably coupled, such that the at least one adjusting member can be removed from the expandable medical implant.
  18. 18. —种撑开具有相对的表面的相邻骨节段的方法,所述方法包括: 将根据权利要求1所述的可扩张医疗植入物插入到所述相对的表面之间; 使所述近侧塞构件和远侧塞构件彼此纵向且独立地移动,使得所述融合器主体的所述近侧端和所述远侧端独立地扩张,以改变所述骨节段的所述相对的表面之间的距离和角度。 18. - The method of seed spreader having opposing surfaces adjacent bone segments, said method comprising: according to claim 1, said expandable medical implant inserted between said opposing surfaces; the the proximal and distal plug member and plug member longitudinally independently of one another, so that the cage body and the distal end of the proximal end to expand independently, to modify the surface of the opposing bone segments of the between the distance and angle.
  19. 19. 根据权利要求18所述的方法,还包括: 在至少一个调节构件已经用于移动所述近侧塞构件和所述远侧塞构件中的至少一个之后,从所述医疗植入物移除所述调节构件。 19. The method of claim 18, further comprising: after at least one regulating member has a proximal plug for moving the plug member and the distal member is at least one, removed from the medical implant In addition to the adjusting member.
  20. 20. 根据权利要求19所述的方法,其中所述骨节段是相邻的椎骨,并且所述相对的表面是所述相邻的椎骨的终板。 20. The method according to claim 19, wherein the bone segments are adjacent vertebrae, said opposing surface and said end plates of adjacent vertebrae.
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US20180153707A1 (en) 2018-06-07 application
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